ii  iitiiir  -ii|iiiii>*i«iiiiiMiiuiinmiiiiiiiwniuumnt»imwiinii»m'i""tMM-iM><nmi  II  ,  i n    i      i     r    fif m 


THE  ABrZ,OF 

OUROWNNUTRITK)^ 

by 
Horace  Fletcher 


\.B,C,Life  Serie: 


rrTriTrtfrrTMinfr-fiitniriiff'"f"'"^""""''"^'^"'^'^^^'^^^"-^^^ 


jQ^n'/fxi'rv 


Digitized  by  the  Internet  Archive 

in  2007  with  funding  from 

IVIicrosoft  Corporation 


http://www.archive.org/details/abzofournutritioOOfletrich 


THE    A.  B.-Z. 


OF 


OUR  OWN  NUTRITION 


.«  » 


HORACE    FLETCHER  S    WORKS 


THE  A.B.-Z.  OF  OUR  OWN  NUTRITION. 
Thirty-fourth  thousand.     462  pp. 

THE  NEW  MENTICULTURE;  or,  The 
A-B-C  OF  True  Living.  Fifty-third 
thousand.     310  pp. 

THE  NEW  GLUTTON  OR  EPICURE; 
OR,  Economic  Nutrition.  Eighteenth 
thousand.     344  pp. 

HAPPINESS  AS  FOUND  in  Forethought 
MINUS  Fearthought.  Fifteenth  thousand. 
251  pp. 

THAT  LAST  WAIF;  or,  Social 
Quarantine.     Sixth  thousand.     270  pp. 


>9n 


The  A.  B.  -  Z. 

of  0\JK  OWN 

Nutrition 


By    HORACE  [FLETCHER,    A.M. 

Author  of  **  Minttcu/turcy"  **  HappinetSj'^  '*  TAat  Last 
Waify'  *•  Glutton  or  Epicure;'  Etc.y  Etc.  Fe/Ioiv 
American    Association  for    tie    Advancement    of   Science 


Including  Italian  Translation 
Thirtt-fourth  Thousand 


NEIF    rORK    .     FREDERICK    A. 
STOKES    COMPANY    .    PUBLISHERS 


\ 


Copyright,  1903 
By  Horace  Fletcher 


A^-^-Ctc: 


S 


•\:  ;.1Wfe;  PLIMPTON 'PBESa 

[wD"-0]     '      ■- 
NORWOOD  •MASS*  U  'S'A 


503 


CONTENTS 

Page 
Introduction ix 

POSTINTRODUCTORY XXvii 

THE   A.  B.-Z.   PRIMER 

Explanation 3 

Some  Pertinent  Questions 4 

A.-The  Psychology  of  Nutrition 6 

B.-The  Mechanical  and   Chemical  Physiology  of 

Nutrition 8 

Method 9 

Z,-The  True  Chemical  End-Point  of  Digestion  .     .  10 

A.  B.-Z.  Figure 12 

Preface  to  1906  Edition 13 

HISTORY  OF  DEVELOPMENT  AND  SUPPORTING 
EVIDENCE 

Summary  of  the  Foregoing  Pages  by  an  Experi- 
menter of  One  Month's  Experience    ....       19 
First   Scientific   Recognition  of  the  Principles  of 
Economic    Nutrition   Outlined   in  "Glutton  or 

Epicure."     H.  F 26 

Was  Luigi  Cornaro  Right  ?  by  Ernest  Van  Someren      27 

The  Cambridge  Tests.     H.  F 47 

Experiments  upon  Human  Nutrition,  by  Sir  Michael 

Foster,  K.  C.  B.,  M.  P.,  F.  R.  S 48 

[iii] 


S1J2ZUT 


Contents 

Page 
Report  of  a  Plan  for  the  Institution  of  an  Inter- 
national  Inquiry  into  the   Subject  of   Human 

Nutrition.     H.  F 53 

Proposal  to  Found  an  International  Laboratory  of 
Research  for  the  Study  of  Nutrition  in  all  Its 
Aspects.     Recommended  by  the  following    .     .       55 
Professors  of  Physiology,  etc. : 

Sir  Michael  Foster,  Cambridge,  England. 
Angelo  Mosso,  Turin,  Italy. 
Hugo  Kronecker,  Bern,  Switzerland. 
N.  Zuntz,  Berlin,  Germany. 
Paul  Heger,  Brussels,  Belgium. 
A.  Dastre,  Paris,  France. 
Henry  P.  Bowditch,  Harvard  Medical  School. 
Russell  H.  Chittenden,  Yale  University. 
William  H.  Welch,  Johns  Hopkins  University. 
J.  P.  Pawlow,  Saint  Petersburg,  Russia. 
Nationality  and  Scientific  Titles  of  the  above  Board 

of  Scientific  Assessors 68 

Persistent  Scientific  Doubts.     H.  F 69 

Physiological  Economy  in  Nutrition,  by  Professor 

Russell  H.  Chittenden 72 

Introduction  to  Dr.  Harry  Campbell's  Contribution 

on  the  Importance  of  Mastication.     H.  F.     .     .       92 
Observations  on  Mastication,  by  Harry  Campbell, 

M.D.,  F.R.C.P 96 

Introduction   to   Professor    Pawlow's    Demonstra- 
tions of  Psychic  Influence  in  Digestion.     H.  F.     180 


Contents 

Page 
Selected  Lectures  by  Professor  J.  P.  Pawlow  (Dr. 

W.  H.  Thompson's  translation) 182 

Lecture  IV. :  General  Scheme  of  an  Innervation 
Mechanism — The  Work  of  the  Nervous  Appa- 
ratus of  the  Salivary  Glands  —  Appetite,  the  First 
and  Most  Potent  Exciter  of  the  Gastric  Secre- 
tion     182 

Lecture  V. :  Period  of  Occurrence  and  Importance 
of  the  Psychic  or  Appetite  Juice  in  the  Secre- 
tory Work  of  the  Stomach  —  The  Inefficiency  of 
Mechanical  Stimulation  of  the  Nervous  Appa- 
ratus of  the  Gastric  Glands 212 

Lecture  VIII. :  Physiological  Action  and  the  Teach- 
ing of  Instinct:  Experiences  of  the  Physician    .     247 
Introduction   to   Dr.   Cannon's   Papers  on   Move- 
ments in  the  Alimentary  Canal  studied  by  Means 

of  the  Rontgen  Rays.     H.  F 284 

Swallowing  and  Movements  of  the  Stomach  and 

Intestines,  by  W.  B.  Cannon,  M.D.     .  -.     .     .     285 
The  Movements  of  the  Food  in  the  CEsophagus, 

by  W.  B.  Cannon  and  A.  Moser 285 

The  Movements  of  the  Stomach,  by  W.  B.  Cannon    301 
The  Movements  of  the  Intestines,  by  W.  B.  Cannon     342 

The  Battle  Creek  Laboratories.     H.  F 389 

Experimental  Investigation  of  the  Influence  of 
Mastication  and  Cooking  of  Food,  etc.,  in  the 
Laboratories  of  the  Battle  Creek,  Michigan,  Sani- 
tarium, under  the  direction  of  Dr.  J.  H.  Kellogg.    391 


Contents 

Page 
Dr.  Edward  Hooker  Dewey  and  the  "  No  Breakfast 

Plan."     H.  F. 396 

Professor  Jaffa  and  the  Fruitarians.     H.  F.    .     .     .  397 

Dr.  H.  P.  Armsby.     H.  F 397 

Explanation  of  the  A.  B.  C.  Series.     H.  F.  .     .     .  399 

Index 409 


rvi] 


INTRODUCTION 


DO  WE  EAT  TOO  MUCH? 
CAN  WE   LEARN  TO   EAT   RIGHT? 
WITHOUT  LOSS  OF   ENJOYMENT? 
WITHOUT   CARE   BEING  A   NUISANCE? 
WITHOUT   SOCIAL   INTERFERENCE? 
WITH  ASSURANCE  OF  HEALTH? 
WITH   INCREASE   OF   ENERGY? 
WITH  INCREASE  OF   ENDURANCE? 


TO  ALL  THESE  VITAL  QUESTIONS, 
THIS  BOOK  ANSWERS  ONLY   "YES. 


VERIFY  THIS   BY  PERSONAL  EXPERIMENT. 
IRRESISTIBLE   DESIRE   FOR   PHYSICAL   EXERCISE 
WILL   FOLLOW,   AS   A  MATTER  OF   COURSE, 
PROBABLY  FRUITING  IN  USEFUL    ACCOMPLISHMENT 
BY  THE   SAME  INVITATION  OF   HEALTHY  IMPULSE 
WHICH   CAUSES   CHILDREN  TO   PLAY  TIRELESSLY. 
DO  RIGHT  YOUR  FEEDING  OF  THE  BODY. 
NATURE  WILL  DO  ALL  THE  REST   FOR  YOU  ARIGHT 


Introduction 

DO   WE   EAT  TOO    MUCH? 

{A  propos  of  the  Scientific-Military  Experiments  at  Yale 
University) 

Do  we  eat  too  much? 

Nine  out    of  every   ten   physicians  tell   us 
"  Yes,"    and   tell    us   true ! 
How  much  too   much? 

Luigi  Cornaro  suggested  that  all  persons  in 
his  time  ate  more  than  was  necessary;  most 
persons  ate   twice   as    much    as   was  good  for  j/ 

them ;  and  some,  who  were  extravagantly  glut- 
tonous, ate  ten  times  as  much  as  was  their  most 
economic  need ;  and  Cornaro,  who  was  a  dissi- 
pated wreck  at  forty,  reformed  his  manner  of 
eating  and  lived  to  be  a  hundred  to  prove  his 
declaration. 

Experiments  carried  on  in  this  country  and 
in  Europe  during  the  past  five  years  confirm 
this  estimate  of  habitual  excess  ;  but  fortunately 
they  have  also  revealed   a   natural  protection, 


Introduction 

heretofore  unappreciated,  available  to  all,  which 
can  regulate  the  appetite  to  suit  the  real  needs 
of  nutrition  and  thus  avoid  the  dangerous  ex- 
cess which  predisposes  to  discomfort  and  disease. 

Luigi  Cornaro  lived  more  than  three  hundred 
years  ago.  His  charmingly  frank  and  interest- 
ing autobiography  has  been  published  in  Eng- 
lish upwards  of  forty  times  in  different  new 
editions,  and  no  one  has  disproved  the  possi- 
bility or  probability  of  his  claim.  We  all  know 
that  Cornaro  was  right.  We  know,  in  a  general 
way,  that  the  great  Italian  dietitian  and  phil- 
osopher was  wise  and  uttered  wisdom,  and  we 
are  told  that  most,  if  not  all,  of  the  diseases 
which  pain,  worry,  and  afflict  us  are  caused 
by  indigestion  or  mal-assimilation  of  food,  the 
result  of  some  indiscretions  of  eating.  The  ques- 
tions then  are  **  What  are  our  indiscretions?" 
"  How  can  we  avoid  them?"  and  "What  is  the 
new  discovery  that  will  protect  us  and,  at  the 
same  time,  add  to  the  pleasures  of  the  palate 
and  of  living?" 

The  answers  to  all  these  queries  will  be 
found  herein,  as  will  also  an  explanation  of  the 
very  active  interest  which  is  being  taken  just 
now  in  the  problem  of  human  nutrition  by 
scientific  and  military  authorities,  as  evidenced 
by  the  Yale  investigation. 


Introduction 

The  author  has,  in  collaboration  with  several 
others,  found  a  way  how  not  to  eat  too  much 
while  eating  all  that  the  appetite  desires,  and  in 
a  way  that  leads  to  a  maximum  of  good  taste 
and  at  a  minirmim  of  cost  and  waste,  but  it  is 
necessary  to  test  many  persons  of  different  phy- 
siques and  varying  temperaments,  and  also  to 
test  other  methods  of  attainment  of  economy, 
to  learn  what  is  best  for  general  application, 
and  that  is  what  is  being  done  at  Yale. 

The  cost  to  the  pocket  that  is  saved  by 
economic  nutrition  is  of  little  matter  as  com- 
pared with  the  saving  of  the  waste  of  energy 
and  the  menace  of  disease. 

Nature  certainly  never  intended  that  we 
should  weaken,  depress,  and  distress  ourselves 
in  the  way  that  is  common  to  present-day  liv- 
ing, as  is  made  evident  by  the  prevalence  of  dis- 
comfort and  disease  relative  to  our  daily  food. 
Nature's  plan  of  evolution  does  not  work  that 
way  in  general,  does  not  retrograde  in  the 
progress  of  the  improvement  of  plants  and 
dumb  animals,  and  certainly  does  not  intend 
that  Man,  the  First  Assistant  of  Nature  in  the 
cultivation  of  things  and  in  the  domestication 
of  the  powerful  natural  forces,  should  suffer  and 
become  degenerate  contrary  to  her  general  law. 
[xi] 


Introduction 

If  we  are  agreed  upon  the  foregoing,  let  us 
ask  ourselves  a  few  questions. 

Without  any  undue  egotism,  may  it  not 
be  possible  for  a  generation  of  human  beings, 
who  have  progressed  so  far  in  intelligence  as 
to  be  able  to  move  things  by  steam,  to  commu- 
nicate across  the  ocean  even  without  wires  to 
guide  our  messages,  and  to  see  clearly  through 
objects  that  are  as  dark  as  night  to  the  unas- 
sisted human  eye  with  the  aid  of  an  artificial 
light,  to  learn  the  secret  of  right  self-nutrition 
and  practise  it  in  a  manner  that  will  not  deprive 
us  of  the  maximum  of  pleasure  which  Nature 
invariably  gives  as  a  reward  for  conformity  with 
her  beneficent  requirements?  May  we  not  as- 
sume that  beings  who  have  learned  to  breed  and 
train  horses  to  race  with  human  intelligence, 
and  to  run,  trot,  or  pace  a  mile  in  less  than 
two  minutes,  may  also  train  themselves  to  have 
the  proportional  relative  speed,  endurance, 
and  longevity  that  has  been  attained  by  race 
horses  through  man's  care,  and  to  enjoy  the 
pleasure  of  living  that  is  evident  in  these  fa- 
voured animals,  mere  servitors  of  man  though 
they  be? 

If  this  disparity  of  man  is  due  to  ignorance 
arising  in  self-neglect,  which  is  the  usual  accom- 
paniment of  genius,  may  we  not  now,  at  the 
[xii] 


Introduction 

beginning  of  the  pregnant  twentieth  century, 
rest  for  a  moment  from  discovering,  developing, 
and  improving  the  world  outside  our  personal 
selves  and  concentrate  our  attention  for  a  while 
on  learning  to  know  and  care  for  ourselves? 
May  we  not,  at  least,  give  "  horse  sense  "  atten- 
tion to  such  a  vital  interest  ? 

In  the  midst  of  the  present  confusion  which 
exists  among  opinions  as  to  the  right  conduct 
of  life  and  activity,  and  the  best  manner  and 
system  of  diet  to  be  used  to  secure  health 
and  efficiency,  it  seems  almost  a  vain  appeal  to 
call  for  concert  of  action  in  a  matter  of  com- 
mon and  persistent  neglect.  Each  person,  as 
his  own  keeper,  is  careless,  and  in  matters  of 
bodily  management  no  one  feels  called  upon 
to  be  his  brother's  keeper;  but  this  is  merely 
the  lethargy  of  oversight  and  consequent  igno- 
rance, and  this  book  is  published  to  call  atten- 
tion to  the  oversight  and  to  attempt  to  dispel 
the  ignorance. 

At  the  present  moment  of  writing  (October, 
1903)  there  are  quartered  at  New  Haven,  Con- 
necticut, twenty  privates  of  the  Hospital  Corps 
of  the  United  States  Army  and  three  non-com- 
missioned officers,  under  the  command  of  As- 
sistant Surgeon,  Lieutenant  Wallace  DeWitt 
[  xiii  ] 


Introduction 

These  men  and  officers,  while  they  are  under 
regular  army  discipline  and  are  performing  duty 
in  conformity  with  their  oath  of  enlistment,  are 
yet  volunteers.  They  are  from  the  same  corps, 
if  they  are  not  the  same  men,  which  furnished 
volunteers  to  investigate  the  causes  of  yellow 
fever  in  Cuba,  whose  heroism  resulted  in  stamp- 
ing the  fever  out  of  the  islands  and  in  that  more 
effectually  protecting  our  coast  states  from  its 
yearly  incursions.  These  are  the  same  men 
who  generously  refused  to  accept  the  offered 
bounty.  This  latter  expression  of  exalted  man- 
hood is  evidence  of  what  humanity  is  whenever 
there  is  real  need  for  heroes  to  serve  the  gen- 
eral good.  They  refused  to  sell  themselves  as 
risks  for  money,  but  they  freely  offered  them- 
selves as  subjects  of  scientific  investigation  for 
the  benefit  of  their  fellows  and  of  mankind  at 
large. 

The  duty  that  the  soldiers  are  engaged  in  at 
Yale  has  no  element  of  risk,  and  need  not  have 
any  feature  of  monotony  or  tediousness  in  it, 
much  less  has  it  the  romance  of  sacrifice,  for  it 
deals  with  an  attempt  to  restore  normality  and 
does  not  consort  with  disease.  But  the  service 
being  rendered  by  these  guardians  of  our  health, 
these  soldiers  of  hygiene,  is  even  more  impor- 
tant than  was  the  service  rendered  in  stamping 
[xivj 


Introduction 

out  yellow  fever,  for  it  deals  with  an  enemy  much 
more  subtle,  treacherous,  common,  and  deadly 
than  Yellow  Jack.  Yellow  fever  calls  for  a  halt 
and  an  immediate  attempt  at  cure,  and  further, 
for  stringent  defence  to  extermination ;  but  in- 
digestion and  the  American  plague,  dyspepsia^ 
work  their  evils  slowly  but  surely  to  cut  off  our 
best  men  and  loveliest  women  in  their  prime  and 
to  rob  us  of  their  richest  product  and  of  their 
maturest  wisdom. 

The  investigation  at  Yale  is  a  link  in  a  chain 
of  effort  that  has  developed  in  logical  sequence 
and  has  been  planned  to  effect  a  cure  of  the 
common  ignorance  and  practice  relative  to  right 
human  nutrition  in  its  relation  to  profitable 
thinking  and  doing ;  and  to  discourage  the  per- 
sonal neglect  which  has  been  responsible  for 
the  existing  ignorance,  this  book  is  issued  to 
show  what  may  easily  be  done  and  what  has 
been  done,  so  far,  in  this  direction.  It  is  a 
compilation  of  important  knowledge  which  has 
been  born  of  recent  scientific  research  but  which 
is  hidden  away  from  common  comprehension  in 
scientific  publications;  and  it  relates  the  story 
of  the  development  of  which  this  book  is  an 
exponent.  Herein  are  given  the  reasons  why 
the  government  and  the  most  eminent  scien- 
tists in  the  line  of  researches  in  nutrition  arc 

[XV] 


Introduction 

cooperating  so  earnestly  and  so  unusually  in  a 
commonweal  inquiry. 

About  ten  years  ago,  at  the  critical  age  of 
forty-four,  the  author  was  fast  becoming  a  physi- 
cal wreck  in  the  midst  of  a  business,  club,  and 
social  tempest.  Although  he  was  trained  as  an 
athlete  in  his  youth  and  had  lived  an  active  and 
most  agreeable  life,  he  had  contracted  a  degree 
of  physical  disorder  that  made  him  ineligible  as 
an  insurance  risk.  This  unexpected  disability, 
with  such  unmistakable  warning,  was  so  much  a 
shock  to  his  hopes  of  a  long  life  that  it  led  to 
his  making  a  strong  personal  effort  to  save  him- 
self. The  study  was  taken  up  in  systematic 
manner,  account  of  which  is  too  long  to  relate 
here ;  but  the  eager  auto-reformer  soon  learned 
that  his  troubles  came  from  too  much  of  many 
things,  among  them  too  much  food  and  too 
much  needless  worry ;  and  realising  the  danger 
ahead,  he  sought  a  way  to  cure  himself  of  his 
disabilities  by  the  help  of  an  economic  food 
supply,  as  did  Luigi  Cornaro ;  but  what  is  even 
more  important,  he  found  a  way  to  enjoy  the 
smaller  quantity  of  food  much  more  than  any 
plethoric  luxury  can  give,  and  arrived  at  the 
method  by  a  route  that  showed  a  means  of 
conserving  a  healthy  economy  and  an  increased 
pleasure  of  eating,  at  the  same  time,  in  quite  a 
[xvi] 


Introduction 

simple  and  scientific  manner,  that  any  ope  may 
learn  and  practise  without  any  ascetic  depriva- 
tion whatever.  Cornaro  buried  the  real  clew  to 
his  economic  and  pleasurable  success  with  his 
body,  owing  to  his  vague  generality  of  descrip- 
tion of  his  method.  The  author  is  determined 
not  to  make  the  same  mistake,  and  thereby  bury 
his  key  to  a  happy  and  easy  life. 

The  secret  of  the  method  is  all  told  in  this 
book  and  is  confirmed  herein  by  both  theoreti- 
cally scientific  and  scientifically  practical  au- 
thority ;  but  the  experiments  which  are  being 
conducted  at  Yale  by  Professor  Chittenden,  in 
cooperation  with  Surgeon-General  O'Reilly  of 
the  army,  of  which  the  Daily  Press  has  given 
notice,  together  with  experiments  which  are  in 
progress  in  many  university  laboratories  in  this 
country  and  in  Europe,  are  for  the  purpose  of 
explaining  the  "reasons  for  things"  by  com- 
plete scientific  reasoning,  so  that  none  may 
doubt  the  disadvantage  and  sin  of  dietic  igno- 
rance and  carelessness. 

The  acceptance  of  the  theory  and  method  of 
the  author  at  the  great  Battle  Creek  Sanitarium, 
after  more  than  a  year's  trial,  and  elsewhere 
among  curative  agencies,  and  their  adoption 
and  use  as  the  first  requisite  of  treatment,  of 
which  the  public  have  not  so  generally  heard, 
[xvii] 


Introduction 

are  indorsements  coming  from  practical,  intel- 
ligent, and  expert  sources  of  experience  and 
judgment,  and  hence  they  are  of  the  utmost 
value  and  significance. 

This  introductory  chapter  is  being  written 
after  the  **  clippings "  of  newspaper  comment 
relative  to  the  presence  of  the  soldiers  at  Yale 
have  begun  to  come  in.  The  majority  of  com- 
ments are  generous  in  spirit,  but  indicate  a  lack 
of  complete  understanding  which  this  "  Intro- 
duction" is  intended  to  correct. 

Some  of  the  comments  are  couched  in  ridi- 
cule, and  express  pity  for  the  poor  soldiers  who 
are  being  **  misused "  as  subjects  of  starvation 
in  an  investigation  which  promises  to  make 
starvation  a  rule  in  the  army.  To  the  writers 
of  such  trifling  and  unfair  paragraphs  let  me, 
one  of  the  fraternity  in  an  amateurish  way,  beg 
consideration  of  the  following. 

The  campaign  that  has  been  started  is  against 
a  common  enemy  of  mankind,  and  of  the  Amer- 
ican and  English  nations  in  particular.  In  our 
successes  in  agriculture,  manufacture,  and  com- 
merce we  have  cultivated  insidious,  luxurious 
temptations  which  bring  all  of  us  some  ill  and 
many  of  us,  or  our  loved  ones,  fatal  disease 
and  premature  death.     The  advance  agent  of 


Introduction 

these  enemies  of  ours  is  Eating-and-drinking- 
too-much. 

The  officers  and  men  of  the  army  and  the 
eminent  scientists  of  our  country  and  those  of 
all  nationalities  who  have  entered  into  the  cam- 
paign with  us,  and  the  great  power  of  the  sani- 
taria joining  as  practical  nurses,  demonstrators, 
and  exponents  of  the  reform,  are  all  working 
for  you  and  for  everybody.  It  is  voluntary 
service  and  has  already  cost  some  of  the  vol- 
unteers much  time  and  patience  and  also  a  con- 
siderable sum  in  money. 

You,  gentlemen  of  the  Press,  wielders  of 
the  helpful  or  careless  pen,  have  a  conspicu- 
ous pulpit  and  a  far-reaching  influence.  No 
one  can  escape  you.  In  the  search  for  the 
news  of  the  day  you  are  encountered  at  every 
turn  in  your  editorials  or  your  paragraphs.  In 
this  campaign  we  need  your  assistance  to  make 
the  cooperation  between  the  army  and  science 
easy  and  effective.  They  are  too  busy  work- 
ing for  you  and  your  best  interest  to  stop  to 
argue  to  correct  your  misunderstanding,  but 
the  cause  will  feel  the  benefit  of  your  assistance. 

Encouragement  has  powerful  influence  in 
stimulating  effort  and  also  in  creating  and  con- 
serving conditions  in  which  men  may  "  do  their 
[xix] 


Introduction 

best."  What  we  are  trying  to  learn  is,  what 
man  may  do,  under  favourable  conditions  of 
knowledge  and  confidence,  to  relieve  his  body 
of  the  strain  of  energy-taxing  labour  in  dispos- 
ing of  the  waste  which  any  excess  of  food 
imposes.  It  is  a  constructive  experiment  and 
not  a  mere  statistical  measurement.  Appreci- 
ation and  applause  assist;  doubt  and  ridicule 
obstruct. 

The  soldiers  and  physiologists  are  too  busy 
studying  indigestion  and  possible  proteid  poison- 
ing and  what-not-other  causes  of  intemperance, 
disease,  and  suffering  to  ask  you  to  assist  in 
spreading  only  serious  report  and  right  sug- 
gestion relative  to  the  importance  and  purport 
of  the  investigation,  but  it  is  my  privilege  to 
ask  it  for  the  general  good. 

Just  another  word  of  introduction  and  then 
will  follow  some  postintroductory  coincidences 
relative  to  the  work  in  hand,  and  then  an 
attempt  to  lay  out  a  ten-page  chart  of  the 
personal  responsibility  in  the  care  of  the  body 
and  the  nourishment  of  the  mind  by  aid  of  an 
economic  and  most  satisfactory  nutrition,  so  as 
to  make  conservation  of  energy  as  easy  as  pos- 
sible and  life  well  worth  the  living.  The  sci- 
entific support  from  the  pens  of  professional 
observers   is,   however,   the    real   meat   of  the 

[XX] 


Introduction 

book,  for  which  compiler  and  reader  alike  arc 
and  should  be  grateful. 

In  serving  in  the  humanitarian  ranks  in  a 
commonweal  campaign  one  should  not  need  to 
use  the  concealment  of  modesty,  nor  should  he 
fail  to  speak  with  all  frankness.  What  are  the 
motives  behind  all  this  energy  to  reform  the 
eating  habits  of  the  people?  The  question  has 
been  so  often  asked  that  it  is  better  thus  pub- 
licly answered. 

No  one  concerned  in  the  campaign  has  any 
personal  monetary  interest  in  any  kind  of  food, 
prepared  or  otherwise.  The  movement  began 
in  a  suggestion  carried  by  an  accidental  word 
given  to  the  author  by  a  friend,  an  old-time 
friend  in  Japan,  and  a  friendship  never  to  be  for- 
gotten, as  related  in  the  author's  book  "  Menti- 
culture."  Pursuit  of  menticulture  led  further  to 
the  discovery  that  the  best  mental  results  could 
not  be  accomplished  in  a  body  weakened  by 
any  indigestion,  any  mal-assimilation  of  nutri- 
ment, any  excess  of  the  waste  of  indigestion. 
Then  came  the  quest  for  the  causes  of  mal- 
nutrition, which  were  soon  found,  by  study  of 
the  natural  sequences  and  by  going  behind  the 
hypotheses  of  text-book  authority,  to  arise  in 
the  careless  ingestion  of  food,  its  neglect  in 
the  mouth,  and  the  consequent  glut  of  unas- 
[xxi] 


Introduction 

similable  excess  within  the  body,  necessitating 
enormous  expense  of  brain  and  body  energy 
to  get  rid  of  the  excess. 

When  the  secret  of  the  potency  for  good  of  a 
rationally  economic  alimentation  was  revealed  to 
the  author,  was  confirmed  by  several  colleagues 
of  different  ages  and  both  sexes,  and  was  tested 
by  work  and  endurance  measurement,  and  also 
by  the  test  time,  it  became  necessary  to  have 
given  to  it  the  indorsement  of  highest  authority 
in  order  to  have  the  information  credited.  The 
new  rediscovery  was  a  simple  matter,  something 
everybody  thought  they  knew  all  about  because 
it  had  been  under  their  nose  all  their  life  and 
was  one  of  the  commonplaces  of  every-day  liv- 
ing, but  for  that  very  reason  it  failed  to  receive 
credence,  and  the  backbone  of  the  doubt  was 
habit  —  lifelong  habit  —  and  this  was  hard  to 
break  even  in  those  who  accepted  the  theory 
of  economic  nutrition  as  a  logical  conviction. 
It  was  also  necessary  to  prove  that  it  was  not 
personal  idiosyncrasy  that  favoured  us,  its 
advocates. 

It  is  in  pursuit  of  the  latter  desideratum  that 
the  officers  of  the  army,  the  scientists,  and  the 
great  humanitarian  health-restoring  institutions 
have  entered  upon  conclusive  investigations, 
each  in  their  own  way,  to  chart  out  a  law  of 
economy  that  will  be  generally  applicable  and 
[  xxii  ] 


Introduction 

which,  it  is  hoped,  can  be  understood  by  kinder- 
gartners  and  mothers  for  the  benefit  of  the 
present  and  of  coming  generations. 

It  was  just  stated  that  no  one  concerned 
in  the  inquiry  was  interested  in  any  food 
product  or  in  any  personally  profitable  busi- 
ness concern,  and  mention  of  the  Battle  Creek 
Sanitarium,  so  widely  known  as  the  pioneer 
in  fostering  the  pure  food  and  prepared-cereal 
manufacture,  may  cast  a  doubt  upon  the  matter 
in  the  minds  of  those  who  do  not  know  that 
the  Sanitarium  organisation,  in  its  every  de- 
partment, is  a  philanthropic,  humanitarian 
institution.  It  is  the  parent  and  feeder  of  the 
American  Medical  Missionary  Cause,  which 
already  has  established  branches  in  something 
over  sixty  localities  situated  in  or  near  large 
cities  in  different  parts  of  the  world,  chiefly 
America.  By  perpetual  charter  all  the  profits 
revert  to  the  spread  of  the  work  and  the  em- 
ployees serve  for  a  mere  pittance,  deriving 
their  major  compensation  from  enjoyment  of 
the  altruistic  work. 

The  old  prejudice  against  the  human  race 
which  declared  that  "  everybody  had  an  axe  to 
grind, "  that  there  was  "  a  nigger  in  every  wood- 
pile," and  such  like  slanders,  must  be  modified 

r  xxiii  1 


Introduction 

in  the  light  of  recent  altruistic  development. 
Altruism  has  always  been  existent  and  had  a 
great  new  birth  with  the  beginning  of  our  era, 
but  it  was  never  before  so  frankly  put  upon  a 
business  basis  as  it  is  now,  and  this  is  fast  being 
applied  to  every  department  of  business  activ- 
ity. It  is  now  done,  not  in  the  name  of  any 
particular  creed  or  cult,  or  for  future  reward, 
but  because  it  pays  —  first,  last,  and  all  the  time. 

In  the  study  and  pursuit  of  menticulture  the 
author  has  found  that  working  for  the  common 
good  is  as  necessary  to  happiness  as  working  for 
self,  and  that  the  retroactivity  and  reciprocity  of 
the  idea  multiplies  the  profits  indefinitely. 

The  sequence  of  profitable,  altruistic  inter- 
relation is  stated  in  the  "  Explanation  "  of  the 
chain  of  the  A.  B.  C.  Life  Series,  of  which  this 
book  is  one  of  the  links. 

Aside  from  those  actively  engaged  in  the 
several  investigations  to  whom  reference  is  often 
made,  the  author  wishes  to  express  special  grati- 
tude to  Sir  Michael  Foster  and  to  Professor 
Henry  Pickering  Bowditch  of  the  Board  of  Sci- 
entific Assessors.  Unselfish  and  unremitting  in 
their  assistance  and  encouragement,  the  author's 
work  has  been  made  easy  since  their  interest 
was  enlisted. 

[  xxiv  ] 


Introduction 

Sir  Michael,  as  Member  of  Parliament  in 
England,  and  as  a  physiological  savant,  knows 
that  economic  nutrition  is  the  key  to  England's 
welfare,  as  well  as  the  basic  necessity  of  tem- 
perance, morality,  health,  and  efficiency,  as  is 
expressed  in  the  two  documents  from  him 
reproduced  in  the  "  Report  of  a  Plan  for  an 
International  Investigation  into  the  Subject  of 
Human  Nutrition  "  and  in  his  "  Note  "  on  the 
Cambridge  examination  of  the  author  and  Dr. 
Van  Someren  at  Cambridge  University  labora- 
tories, given  herein. 

Professor  Bowditch,  as  a  distinguished  physi- 
ologist, publicist,  and  especially  as  the  Presi- 
dent of  the  Children's  Aid  Society,  of  Boston, 
Massachusetts,  often  mentioned  as  the  model 
institution  of  its  kind  in  the  world,  realises  that 
the  effort  of  the  author  to  secure  basic  knowl- 
edge relative  to  right  nutrition,  adaptable  to 
kindergarten  teaching  and  home  training  dur- 
ing the  impressionable  period  of  youth,  is  of 
the  greatest  importance  in  social  reform. 

A  trial  suggestion  relative  to  ways  and  means 
of  beginning  right  with  all  the  children  and  thus 
insuring  a  regeneration  of  the  classes  most  in 
need  of  reform,  in  not  longer  than  two  decades, 
is  outlined  in  the  author's  appeal  for  the  waifs 
of  society,  entitled  "  That  Last  Waif;  or  Sociai 
Quarantine." 

[xxv  I 


Introduction 

Whenever  there  is  any  disposition  to  slack 
up  in  patience  or  enthusiasm  to  accomplish  the 
ultimate  end  aimed  at,  the  picture  of  the  waif  in 
that  story  is  flashed  back  by  memory,  and  there 
can  be  neither  forgetfulness,  indifference,  nor 
repose  until  "  that  last  waif "  has  been  given  at 
least  a  chance  of  choosing  between  the  right  and 
the  wrong,  the  good  and  the  bad. 


f  xxvi  J 


POSTINTRODUCTORY 

[Just  before  "  going  to  press  "  the  author  has 
received  a  letter  from  his  esteemed  colleague, 
Dr.  Hubert  Higgins,  giving  the  gist  of  inter- 
views with  an  eminent  European  physiologist 
and  with  a  famous  American  chemist  and  dieti- 
tian, which  so  well  describes  the  attitude  of  the 
scientific  mind  towards  the  problem  of  human 
nutrition  that  the  scientific  mentor  of  the  writer 
advises  its  addition  to  the  book. 

By  the  same  post  there  arrived  a  letter  from 
Dr.  J.  H.  Kellogg,  the  life  and  director  of  the 
Battle  Creek  Sanitarium,  expressing  practical 
appreciation,  the  result  of  demonstration,  of 
what  is  being  done  to  solve  the  problem. 

Eliminating  the  personal  element  and  keep- 
ing the  ultimate  object  in  view,  these  communi- 
cations are  coincidentally  a  propos  and  intimate 
to  our  **  Introduction  " ;  hence  their  reproduc- 
tion here. 

Numerous  other  letters  and   extracts   from 

communications  received  by  the  writer,  bearing 

upon   this  subject,   from  the  above  and    other 

sympathetic    friends   are    reproduced    in   "The 

[  xxvii  ] 


Introduction 

New  Glutton  or  Epicure,"  a  free  and  easy  com- 
panion of  this  book,  intended  to  appeal  to  a 
variety  of  readers. 

When  it  is  known  that  the  proceeds  of  all 
the  publications  of  the  author  are  dedicated  to 
the  promotion  of  the  objects  they  advocate, 
reference  to  them  or  advertisement  of  them 
cannot  be  considered  inappropriate.  —  Horace 
Fletcher.] 

Extracts  from  Dr.  Higgins'  Letter 

Palazzina  Tasso, 

Campo  S.  Polo, 
Venezia. 
October  3,  1903. 

Dear  Mr.  Fletcher,  —  A.  appears  to  me 
to  have  an  exceedingly  broad  and  philosophic 
grasp  of  the  problem  of  nutrition. 

He  recognises  that  all  present  data  are  sub- 
ject to  criticism,  and  that  there  are  no  scien- 
tifically accurate  data  available  because 

{a)  Observations  are  taken  over  too  short  a 

period. 
(J))  They  have  mainly  dealt  with  one  side 

of    the    problem,  —  the    output  of 

muscular  work. 
{c)  The    observations    are    not   sufficiently 

complete. 

[  xxviii  ] 


Introduction 

He  acknowledges  that  cleavage  products 
from  food  broken  down  in  the  intestines  by 
bacteria  are  the  cause  of 

(ji)  Inefficiency 
(J))  Diseases 

(r)  Mental  derangements. 
(See  Mott's  work.) 

He  recognises  that  the  majority  of  people 
eat  far  too  much.  He  puts  this  in  the  following 
way.  If  a  **  mediaeval  devil "  had  wished  to 
discover  the  most  subtle  and  most  effective  way 
to  destroy  mankind  mentally,  morally,  and 
physically,  he  would  have  arranged  for  them 
to  be  supplied  with  tasty,  well-cooked  foods, 
wines,  etc. ;  in  short,  he  would  have  used  every 
means  to  tempt,  confuse,  and  pervert  their  ap- 
petite. He  would  also  have  arranged  every 
possible  means  to  prevent  their  being  in  the 
fresh  air  and  taking  exercise.  He  thinks  one 
has  here  the  picture  of  modern  civilisation. 

He  talked  in  a  very  interesting  and  instruc- 
tive manner  about  the  necessity  and  value  of 
exercise  and  a  muscular  body  for  the  mainte- 
nance of  good  health.  He  has  evidently  worked 
at  and  thought  a  good  deal  about  this  side  of 
the  subject. 

He  regrets  that  there  are  not  more  people 
who  realise  the  huge  importance  of  under- 
[  xxix  ] 


Introduction 

standing  the  nutrition  problem  for  the  sake 
of  the  progress  of  humanity.  He  would  like 
to  join  all  those  who  are  interested  in  forming 
an  international  society,  as  far  as  I  understood 
him. 

He  is  most  keen  on  getting  subjects,  such 
as  myself,  for  study  over  a  very  long  period  of 
time,  —  two  to  three  years,  —  as  he  very  justly 
observed  **  Muscular  output  is  a  very  small 
part  of  the  measure  of  a  man's  efficiency. 
Mental  efficiency,  manual  dexterity,  and  other 
psychological  tests  are  necessary."  He  seemed 
very  much  interested  in  my  idea  of  making  a 
large  number  of  curves  of  daily  observations. 
He  said  that  it  appeared  to  him  to  offer  the 
best  means  of  ultimately  measuring  the  degree 
of  deviation  from  the  subject's  optimum  state 
of  health. 

He  argues  the  necessity  of  getting  some 
scientific  definition  of  health. 

The  phrase  that  reduces  all  these  people  to 
contemplative  silence  is  this. 

"  You  acknowledge  that  the  state  of  knowl- 
edge is  insufficient  to  prescribe  a  diet  for  any 
individual  that  he  should  take  daily;  or  in 
other  words,  that  there  is  very  little  accurate 
knowledge  of  the  nutrition  problem." 

Reply.     "Yes.     I  do  not  feel  I  could  pre- 

[  XXX  ] 


Introduction 

scribe  a  diet  for  any  one  with  any  degree  of 
confidence." 

"Very  well,  then.  Why  should  not  the 
body  have  or  acquire  the  quality  that  all  ani- 
mals have,  in  a  free,  natural  state,  of  knowing 
what  their  body  wants  by  appetite  and  taste?" 

This  is  more  or  less  how  you  put  it  to  me 
when  I  first  met  you  at  Cambridge.  Its  full 
significance  did  not  dawn  on  me  till  much  later; 
till,  in  short,  I  commenced  the  study  of  my 
desires  at  Cambridge. 

Now  this  point  of  view  is  the  rock  on  which 
we  stand,  and  is  the  cause  of  H.'s  and  A.'s  in- 
terest, and  as  H.  said,  is  the  "  most  fascinating 
idea"  he  ever  heard. 

It  had  very  much  the  same  effect  on  A.  He 
was  reduced  to  silence.  The  more  you  think 
of  it  the  more  you  see  there  is  no  answer  that 
could  contradict  it. 

He  then  admits  that 

(tf)  The  food  should  be  finely  divided. 

(^)  That  it  should  be  thoroughly  insalivated. 

(^)  That  in  all  probability  most  diseases  are 

caused  by  dietetic  error. 
id)  That  we  have  still  to  find  the  optimum 

health  and  the  optimum  diet. 

He  only  kicks  at  the  low  proteid.     Now  I 
don't  care   a  "  kuss "   for   the   low  proteid,   as 
[  xxxi  ] 


Introduction 

such,  or  high  proteid.  Proteid  like  everything 
else  will  be  demanded  by  the  appetite  when  it 
is  wanted. 

Our  great  danger,  to  my  mind,  is  the  ten- 
dency so  strongly  exemplified  by  some  of  pre- 
scribing diets  and  quantities  and  the  length 
the  time  food  should  be  chewed.^  Now  the  very 
errors  we  are  fighting  against  are  the  prescrip- 
tion of  methods  on  insufficient  information  or 
knowledge.  You  have  gone  straight  back  to 
Nature,  There  is  your  strength  in  convincing 
the  scientific  world,  and  we  must  study  the 
problem  from  that  point  of  view  if  we  are  to  get 
any  great  degree  of  success. 

A.  had  nothing  to  say  when  I  told  him  that 
I  did  not  hold  by  either  high  or  low  proteid  but 
only  by  my  appetite  and  taste,  developed  by 
ample  mouth  opportunity  to  discriminate,  which 
I  hoped,  in  time,  to  understand  more  thor- 
oughly than  I  do  now.  He  told  me  that  he 
feared  that  there  would  be  great  physical  de- 
terioration after  a  long  period  of  low  proteid. 
I  said  that  I  did  not  believe  it  would  be  the 
case  by  your  method.  For  instance,  right  in 
the  midst  of  a  long  period  of  most  satisfactory 
low-proteid  supply,  I  once   ate  nearly  a  whole 

1  Appetite  alone  can  judge  accurately  of  the  former,  and 
the  true  Swallowing  Impulse  is  the  limitation  of  the  latter.     If 
wc  study  the  natural  instincts,  the  rest  will  take  care  of  itself. 
[  xxxii  ] 


Introduction 

chicken  with  some  ham  at  Penegal.  I  could  not 
get  saliva  for  anything  else.^  In  short,  then,  I 
insisted  only  on  thorough  mastication  to  protect 
taste  and  appetite,  and  had  no  other  theories. 
I  was  only  concerned  in  observing  the  factors 
determining  my  taste  and  appetite.  I  would  be 
more  than  contented  to  leave  the  question  of 
minimum  and  maximum  quantity  of  proteid  to 
be  settled  in  the  future  after  normality  had  been 
established  by  practical  demonstration. 
Yours  faithfully, 

Hubert  Higgins. 
# 
Extracts  from  Dr.  Kellogg's  Letter 


Mr.  Horace  Fletcher. 


Battle  Creek,  Mich. 
October  7,  1903. 


Dear  Friend,  —  Yours  of  September  30th 
just  reached  my  hands  and  I  hasten  to  reply. 

I  saw  a  newspaper  note  in  reference  to  the 
soldiers  which  the  government  has  selected  for 
the  dietetic  experiments,  and  also  read  an  inter- 
esting article  in  the  Popular  Science  Monthly. 
You  have  accomplished  a  great  good  thing  in 
enlisting  these  scientific  and  military  men  and 
interesting    them    in    the   investigation   of  this 

1  This  is  very  strong  evidence  that  appetite  knows  what 
to  do  and  when  to  do  it,  if  you  study  and  consult  it  and  give 
it  a  chance  to  prescribe. 

[  xxxiii  ] 


Introduction 

wonderful  reform.  The  marvellous  thing  about 
it  is  that  these  busy  men  of  science  should  have 
so  readily  undertaken  an  investigation  which 
involves  so  much  surrender  and  self-denial,  at 
least,  at  the  start.  I  know  you  are  absolutely 
right.  My  personal  experiences  and  observa- 
tions confirm  me.  In  the  experiments  you 
mention,  which  I  made  in  reference  to  the  daily 
ration  for  ordinary  persons,  I  simply  sought  to 
ascertain,  as  have  others,  how  much  and  what 
kinds  of  food  people  are  in  the  habit  of  using, 
taking  no  account  of  the  possible  excess  or  the 
careless  manner  in  which  they  eat.  The  figures 
I  got  were  sixteen  ounces  of  starch;  1.2  ounces 
fat,  and  three  ounces  proteids,  —  approximately 
2,500  calories.  In  observation  of  patients  I  have 
seldom  found  one  able  to  eat  this  amount. 
Personally,  I  habitually  eat  scarcely  half  as 
much.  My  breakfast  to-day  was  the  yolks  of 
two  eggs,  two  or  three  tablespoonfuls  of  corn 
flakes,  a  moderate-sized  potato,  and  a  couple  of 
peaches.     At  dinner  I  shall  take  a  little  more. 

I  have  been  so  busy  with  my  patients  and 
the  new  building,  getting  things  organised,  that 
I  have  not  done  as  much  as  I  ought  to  in  the 
way  of  promoting  your  splendid  reform ;  but  I 
am  going  at  it  now  in  good  earnest.  I  feel  it  is 
one  of  the  greatest  things  in  sight,  and  it  fits 
right  in  to  all  the  other  things  I  am  trying  to 
[  xxxiv  ] 


Introduction 

do.  I  feel  that  I  owe  you  continually  a  great 
debt  for  the  efforts  you  have  made  and  the 
splendid  work  you  are  doing,  which  will  accom- 
plish more  for  the  uplifting  of  humanity  than 
all  that  Carnegie  and  Rockefeller  are  doing  with 
their  millions.  What  they  are  doing  is  mainly 
to  perpetuate  old  errors,  while  you  are  bringing 
out  new  truth  of  basic  importance,  and  a  kind 
Providence  has  certainly  inspired  you  to  do  this 
grand  work. 

I  thank  you  for  all  your  good  thoughts 
towards  us,  and  assure  you  the  loving  encour- 
agement your  letters  always  contain  is  very 
much  appreciated,  and  sometimes  it  gives  us  a 
mental  uplift  just  when  we  need  it.  The  road 
we  are  travelling  over  is  not  altogether  free  from 
thorns.  All  your  suggestions  are  gratefully 
received.     I  remain, 

Faithfully  yours, 

J.  H.  Kellogg. 


[xxxv] 


A.  B.-Z.    PRIMER 


EXPLANATION 

THIS  is  a  condensed  presentment  of  a  sub- 
ject of  basic  importance  to  everyone, 
supported  by  numerous  appendices  of  great 
scientific  weight. 

The  special  object  of  such  brevity  and  ele- 
mentary treatment  of  the  subject  is : 

I  To  accentuate  the  facts  showing  how  little 
*  •  we  really  have  to  know  and  do  in  con- 
nection with  our  sustenance  in  order  to  have  the 
Natural  Automatic  Processes  done  rightly 
and  healthfully. 

^  To  permit  busy  persons  who  will  take  our 
^*  dictum  as  gospel  and  our  advice  as  sound 
to  learn  their  necessary  share  in  their  own  nutri- 
tion in  the  least  possible  time,  leaving  the  less 
credulous  and  more  curious  to  study  the  appen- 
dices at  leisure  and  at  will. 

-2  For  some  ten  years  it  has  been  the  ambition 
*^*  and  the  aim  of  the  older  and  non-professional 
author  to  embody  the  fundamental  essentials  of 
human  responsibility  in  self-understanding  and 
self-management  in  not  more  than  ten  pages  of 
coarse  print  that  a  child  could  understand  and 
that  mothers  and  teachers  might  commit  to 
memory  and  never  forget. 

This  is  only  a  first  trial-attempt  to  fulfil  the 
ambition  and  the  aim ;  but  the  appendices  show 
the  assembling  and  concentration  of  scientific 
and  militant  forces  which  will  not  allow  this  sub- 
ject of  primal  human  interest  to  remain  longer 
the  most  neglected  of  educational  departments. 

[3] 


SOME     P  E  R  T I N  E  N  T 
QUESTIONS 


w 


ILL  the  reader  not  ask  himself  the  follow- 
ing questions  ? 

I  How  much  do  I  know  about  my  own  nutri- 
*•    tion? 

^  Do  I  know  the  particular  need  and  purpose 
^*  of  my  last  meal  and  what  it  is  likely  to 
accomplish? 

-y  Considering  my  body  as  an  engine,  would 
*^*  I  accept  myself  as  a  competent  engineer  on 
my  own  examination  and  confession  ? 

A  Were  I  an  iron  and  steel  automobile,  instead 
^*  of  a  flesh  and  blood  automobile,  which  I 
really  am,  could  I  get  a  license  for  myself,  as  a 
chauffeur,  to  run  myself  with  safety,  based  upon 
my  knowledge  of  my  own  mechanism  and  the 
theory  and  development  of  my  power? 

pj  Were  I  an  owner  of  valuable  live-stock, 
*'•  would  I  employ  a  farm-hand  or  a  stable 
man,  even  at  so  low  a  wage  as  fifteen  dollars  a 
month,  who  knew  as  little  about  the  proper 
feeding  of  my  animals  as  I  know  about  the 
proper  feeding  of  myself  and  my  children? 

^.  Should  I  employ  such  an  ignorant  attend- 
^*  ant  for  my  live-stock,  and  catch  him  worrying 
them  during  their  feeding,  and  hurrying  them 
away  from  their  fodder  to  hitch  them  up  for  work, 
would  I  not  have  the  man  arrested  for  cruelty 
to  animals?  And  yet  this  is  what  is  habitually 
done  to  children ! 

[4] 


SOME    PERTINENT    QIJESTIONS—  Continued 

$m  Do  I  appreciate  how  important  it  is  to  learn 
'•  sufficient  of  the  requirements  of  economic 
and  healthy  nutrition  to  enable  me  to  escape 
the  depressing  and  debilitating  effects  of  a 
faulty  nutrition. 

0  How  can  I  religiously  "  ask  a  blessing " 
^*  upon  food  and  then  immediately  sin  by 
treating  it  in  a  manner  abhorrent  to  the  natural 
requirements? 

Q  If  "  cleanliness  is  next  to  godliness  "  is  it 
^'  respectable  for  me  to  slight  my  proper 
feeding  in  a  manner  that  I  know  may  induce 
putridity  of  excreta  through  indigestion  and 
that  may  produce  fatal  disease? 

1  r\  With  All  Eternity  ahead  of  me,  cannot  I 
*  ^*  afford  at  least  %§*  of  ^y  time  for  careful 
feeding  of  my  body  in  a  manner  known  to 
favour  physical  health  ;  mental  keenness ;  firm- 
ness of  character;  enjoyable  temperance;  sex- 
ual vigour  without  morbidity.  In  fact,  general 
respectability  and  efficiency? 

Having  duly  reasoned  out  logical  answers  to 
the  questions,  may  they  not  seem  sufficiently 
important  to  be  remembered  and  respected  as 
a  Dietary  Ten  Commandments  ? 

*  The  Yale  test  reported  herein  by  Professor  Chittenden 
showed  the  possibility  of  full  alimentation  according  to  the 
requirements  of  Economic  Nutrition  in  from  24  to  26  minutes 
daily,  which  is  less  than  \is  of  a  day.  Beginners  of  the  prac- 
tice of  careful  mouth-treatment  of  their  food  may  require 
more  time,  but,  whatever  it  may  be,  it  is  worth  it.  A  little 
care  for  a  short  period  will  establish  a  right  habit,  and  then 
no  further  tedious  attention  nor  unusual  time  will  be  neces- 
sary to  accomplish  a  perfectly  healthy  nutrition. 

[s] 


A  The  Psychology  of  Nutrition 
APPETITE     ATTENTION 
APPRECIATION 

Appetite  is  the  most  important  factor  in 
digestion  (vide  Pawlow). 

Normal  Appetite  is  indicated  by  a  desire 
for  some  particular  simple  food  accompanied 
by  a  "  watering  of  the  mouth." 

False  Appetite  is  a  general  discontent  of 
the  body,  indefinite  of  description.  It  is  often 
expressed  by  "  all  gone-ness,"  or  stomach  crav- 
ing, and  calls  for  somethingy  Anything!  to 
smother  the  discomfort  of  present  or  recent  in- 
digestion. It  is  like  the  thirst  which  follows  a 
debauch. 

Ignore  False  Appetite,  and  Wait  for 
a  Return  of  Normal  Appetite.  It  will  come 
as  soon  as  body  repairs  have  been  effected  by 
natural  agencies  and  more  material  is  required. 
No  one  was  ever  injured  by  intelligently  and 
calmly  waiting  for  an  appetite.  No  one  ever 
starved  to  death  for  lack  of  appetite.  Most 
human  ills  come  from  forcing  appetite,  antici- 
pating appetite,  abuse  of  appetite  in  some  form. 

Appetite  is  the  most  important  factor  in 
nutrition.  This  estimation  is  based  upon  evi- 
dence given  more  fully  in  the  various  appen- 
dices, but  the  measure  of  its  importance  may  be 
briefly  stated,  as  follows  :  — 

EV  /  In  its  normal  state,  Appetite  is  a  per- 
fect indicator  of  the  bodily  need  of 
nutriment  and  moisture,  both  as  to  quantity  and 
as  to  the  chemical  elements  required  at  the 
moment. 

[6] 


APPETITE,  ATTENTION,   Sec.  —  Continued 

«  ^   Appetite  is  a  creature  of  the  mind 

and  does  not  attach  to  a  tissue.  It 
can  be  as  easily  changed,  from  abnormal  to 
normal,  by  suggestion,  as  can  the  mind  itself, 
and  is  not  like  a  solid,  the  form  or  habit  of 
which  has  been  set  in  a  mould.  Whoever  has 
once  experienced  a  bad  oyster  and  has  abhorred 
oysters  ever  after  will  substantiate  this  claim 
regarding  the  caprices  of  appetite. 

77i7V//    Appetite  can  be  easily  comprehended 
and  read  and  the  degrees  of  its  sat- 
isfaction   understood  by   simple   attention   and 
study  for  a  brief  period  (vide  Van  Someren). 

*y,  ^T  Attention  is  necessary  to  create 
l^ourm  Appreciation,  and  appreciation  is 
absolutely  necessary  to  stimulate  the  secretion 
and  flow  of  gastric  and  other  digestive  juices 
(vide  Pawlow). 

W-ri-h  -^NGER,  or  shock  of  any  kind,  and 
HZJin  \YoRRY,  or  any  of  the  pessimistic  de- 
pressants, stop  digestive  activity  and  cause  indi- 
gestion (vide  Cannon). 

9  *^h  Menticulture  should  begin  with  its 
application  to  selection  (through  a 
normalised  appetite)  of  nutriment  for  the  body, 
and  continue  to  aid  digestion  by  right  thinking. 
It  is  very  easy  to  cultivate  calm  and  fortify 
against  surprise,  shock,  and  anger  if  the  nutri- 
tion of  the  body  is  carefully  attended  to.  The 
physical  and  the  mental  equipments  are  beauti- 
fully reciprocal  and  necessary  to  each  other  in 
promoting  Menticulture. 

[7] 


B 


The  Mechanical  and  Chemical 
Physiology  of  Nutrition 

BUCCAL   DIGESTION 
THROUGH 

MOUTH  THOROUGHNESS 


Mouth  treatment  of  food,  which  permits,  aids, 
and  includes  insalivation  (mixing  with  saHva), 
and  which  is  both  actively  digestive  in  its  func- 
tions and  preparatory  to  final  digestion,  is  the 
only  actual  mechanical  responsibility  we  have  in 
our  nutrition;  and,  in  connection  with  favour- 
able A  conditions,  insures  perfect  digestion.  It 
has  been  so  fully  and  clearly  explained  in  some 
recent  articles,  "  Observations  on  Mastication," 
by  Dr.  Harry  Campbell,  F.R.C.P.,  physician  to 
the  Northwest  London  Hospital,  printed  in  the 
**  Lancet"  of  July  nth,  i8th,  25th,  and  August 
8th,  1903,  that  reference  to  the  articles,  reprinted 
herewith,  is  all  that  is  necessary  here. 

In  giving  attention  to  careful  mouth-treatment 
of  soft  or  Hquid  foods  until  they  are  absorbed 
by  the  Swallowing  Impulse  the  best  health  and 
economic  results  are  obtained.  It  should,  at 
least,  be  tried. 

This  will  not  be  found  to  be  a  tedious  opera- 
tion after  a  little  practice,  when  the  habit  of 
attention  and  care  has  been  formed.  On  the 
contrary,  a  new  appreciation  and  enjoyment  of 
taste  will  be  acquired,  the  delight  of  which  has 
to  be  experienced  to  be  understood. 

Some  hints  on  learning  how  to  read  the  appe- 
tite, command  the  attention,  and  masticate  and 
swallow  food  material  properly  follow. 

[8] 


METHOD 


Fivst ;   Last;    Be  sure  that  you  are  really 
CLTlcL  hungry   and    are    not    pam- 

All  the  Time  P;^'"^   ^^^'5.  ^£.Pf  *'*-n 

If  true  appetite  that  will 
relish  plain  bread  alone  is  not  present,  wait  for 
it.  Especially  beware  of  the  early-morning 
habit-craving.  Wait  for  an  earned  appetite,  if 
you  have  to  wait  till  noon.  Then:  "Chew," 
"Masticate,"  "  Munch,"  "Bite,"  "  Taste"  every- 
thing you  take  in  your  mouth  (except  water, 
which  has  no  taste),  until  it  is  not  only  thor- 
oughly liquefied  and  made  neutral  or  alkaline 
by  saliva,  but  until  the  reduced  substance  all 
settles  back  in  the  (glosso-epiglottidean)  folds 
at  the  back  of  the  mouth  and  excites  the 
Swallowing  Impulse  into  a  strong  inclination 
to  swallow.  Then  swallow  what  has  collected 
and  has  excited  the  impulse,  and  continue  to 
chew  at  the  remainder,  liquid  though  it  be, 
until  the  last  morsel  disappears  in  response  to 
the  Swallowing  Impulse.  Never  forcibly  swal- 
low anything  that  the  instincts  connected  with 
the  mouth  show  any  disposition  to  reject.  It 
is  safer  to  get  rid  of  it  beforehand  than  to  risk 
putting  it  into  the  stomach. 

Sip  and  taste  milk  and  all  liquids  that  have 
taste  as  the  wine-tasters  do.  They  never  drink 
wine  and  yet  they  get  all  the  enjoyment  there 
is  in  it  and  waste  none.  In  a  very  short  time 
sipping  and  tasting  liquids  and  masticating  and 
tasting  solid  food  for  "  all  they  are  worth  "  will 
become  an  agreeable  and  profitable  fixed  habit. 

Whether  We  "  Eat  to  Live  or  Live  to 
Eat,"  why  not  do  as  Above? 

[9] 


z 


The  True  Chemical  End-Point 
of  Digestion 


THE    DIGESTION-ASH    WHAT    IT 

SHOULD    BE    LIKE   WHEN 

IT  IS  NORMAL 

77 Vc/  ^^  adults;  or,  in  children  after  the 
eruption  of  teeth  and  the  ingestion  of 
solid  food :  The  non-liquid  and  non-gaseous 
waste  of  the  human  body,  which,  in  its  normal 
state,  is  not  offensive,  should  be  very  small, 
in  quantity,  should  be  pillular  in  form,  either 
separate  or  massed  together;  should  have  no 
odour  when  released,  should  take  on  no  odour 
on  standing,  should  be  entirely  aseptic  (non- 
poisonous)  ;  should  drop  freely  from  the  exit, 
leaving  nothing  behind  to  wash  or  wipe  away. 
It  may  not  be  collected  in  the  intestines  of  full- 
grown  and  elderly  persons,  when  normal,  as 
above,  in  sufficient  quantity  to  require  or  neces- 
sitate emptying  oftener  than  from  twice  a  week 
to  once  in  two  weeks ;  according  to  age,  activ- 
ity, etc. ;  and  should  neither  invite  nor  justify 
the  description  "  it  is  not  that  which  goeth  into 
a  man  that  defileth  him  but  that  which  cometh 
out." 

ri  ^   Economic  Digestion-Ash  (solid  ex- 

creta) y  as  a  daily  average  for  an 
adult  of  140  lbs.  (10  stone;  63.5  kilos),  includ- 
ing moisture,  when  released,  should  not  weigh 
more  than  two  ounces  (56.70  grams).  An  aver- 
age of  less  than  one  half  this  amount  of  waste 
has  been  secured  in  test  experiments. 

[10] 


THE    DIGESTION-ASH,    &c.  —  Continued 

^,  .  ,  The  true  test  of  healthy  Z  is  absence 
I  mvCL  q£  odour  and  completeness,  ease  and 
cleanliness  of  delivery.  Frequency  or  other- 
wise, does  not  so  much  matter.  Quantity  too, 
is  not  so  important;  but  with  foul  odour  there 
is  disturbance,  strain  and  danger. 

The  normal  man  is  a  cleanly  being  with  all 
excreta  inoffensive;  and  by  these  tokens  he 
may  be  his  own  private  judge. 

Why  is  it  that  barn-yards  are  tolerable  to 
the  human  senses  while  open  depdts  of  human 
excreta  are  fever-breeding  nuisances  and  intol- 
erable to  beasts  and  humans  alike  ? 

This  curse  of  putrid  excreta  caused  more 
deaths  from  enteric  fever  during  the  Boer  War 
in  South  Africa  than  all  other  causes.  It  is 
equally  a  menace  to  health  and  even  to  life 
while  being  formed  and  carried  in  the  body. 

J?ryfjt^h  Offensive  excreta  are  quite  certain 
roid^TTrl  gyjjjejjce  of  neglect  of  the  self-con- 
trollable parts  of  our  own  nutrition.  They  are 
the  tell-tale  condemnation  of  ignorance  or  care- 
lessness. Each  person  should  learn  to  read  the 
true  bulletins  of  his  health  conditions  in  his 
waste-products  of  digestion. 

Zis  the  form  the  body  w/<5J/ assume  to  render 
emptying  of  the  digestion-ash  natural  and 
easy.  Man  was  built  to  squat  on  his  heels  in 
defecating,  and  sitting  erect  on  a  modern  seat 
is  like  trying  to  force  a  semi-solid  through  a 
kinked  hose.  HEALTHY  Human  Excreta  are 
NO  MORE  Offensive  than  Moist  Clay  and 
have  no  MORE  Odour  than  a  Hot  Biscuit. 


A.   B.-Z.    FIGURE 

TO    ILLUSTRATE    THE     «*DIVISION    OF 
LABOUR" 


C"      /       A    Psychic  Environment  /  This 

t^trsi.      A    Mental  State  \  involves : 

Appetite  (to  select  for)        ^ 

Attention  (to  prepare  for)  V    DIGESTION 

Appreciation  (to  assist  in)  j 

(Absolutely  necessary  to  secure  secretion  and 

flow  of  the  digestive  juices :  Vide  Pawlow  and 

Cannon.) 

«  »      B   BUCCAL- digestion  )  This 

^^eC07^a.     a    mquth-treatment  j  involves : 

CH^^MTA'cLfivalf  ?    THOROUGHNESS 
(Absolutely  necessary  to  secure  complete  diges- 
tion and  avoid  the  putridity  incident  to  bacterial 
decomposition :  Vide  Campbell  and  Van  Some- 
ren.) 

INTERMEDIATE  S^r  "'S'' T„d''.-T" 
represent  but  an  inadequate  proportion  for  the 
spelling  of  the  enormous  share  Nature  assumes 
in  our  welfare,  marvellously  performing  her 
forty-seven  forty-eighths  share  in  the  secret 
laboratory  of  the  alimentary  canal. 

77>  *  rf  7  '^^^  ^^"^  chemical  end-point  of 
digestion,  by  which  each  self- 
respecter  may  know  how  well  he  has  respected 
his  "A"  and  his  "  B,"  and  how  faithfully  he 
has  performed  his  one  forty-eighth  share  in 
the  promotion  of  his  own  most  fundamental 
interest. 


PREFACE 
TO   1906  EDITIONS 

Since  the  former  introductions  were  written 
much  success  has  been  attained  in  further  ad- 
vancing the  reforms  advocated  in  the  A.  B.  C. 
Life  Series.  Professor  Chittenden  has  pub- 
lished his  report  on  the  Yale  experiments  in 
book  form  in  both  America^  and  England,^ 
and  his  results  have  been  accepted  in  scientific 
circles  the  world  over  as  authoritatively  con- 
clusive. 

At  the  present  writing  the  most  important 
Health  Boards  of  Europe^  are  planning  to  put  the 
new  standards  of  dietary  economy  into  practical 
use  among  public  charges  in  a  manner  that  can 
only  result  in  benefit  to  the  wards  of  the  nations 
as  well  as  make  an  important  saving  to  the  tax- 
payers. In  the  most  important  of  these  foreign 
public  health  departments  the  Health  Officer  of 
the  Board  has  himself  practised  the  newly  es- 
tablished economy  for  two  years,  and  his  plans 

1  Physiological  Economy  in  Nutrition  :  The  Frederick  A. 
Stokes  Company,  New  York. 

2  William  Heinemann  :   London. 

*  The  author  is  not  yet  permitted  to  publish  the  particulars 
of  these  reforms  in  process,  but  he  has  official  information 
regarding  them  and  is  in  full  sympathy  with  then). 

[■3] 


PREFACE   TO    1906   EDITIONS  —  Contwue^i 

are  formulated  on  personal  experience  which 
fully  confirms  Professor  Chittenden's  report  and 
that  of  the  author  as  herein  related. 

At  a  missionary  agricultural  college,  situated 
near  Nashville,  Tenn.,  where  the  students  earn 
their  tuition  and  their  board  while  pursuing 
their  studies,  a  six  months'  test  of  what  is  termed 
"  Fletcherism  "  resulted  in  a  saving  of  about  one 
half  of  the  drafts  on  the  commissary,  immunity 
from  illness,  increased  energy,  strength  and  en- 
durance, and  general  adoption  of  the  suggestions 
published  in  the  several  books  of  the  author  in- 
cluded in  the  A.  B.  C.  Life  Series. 

In  the  various  departments  and  branches  of 
the  Battle  Creek  Sanitarium  in  America,  and 
widely  scattered  over  the  world,  some  eight 
hundred  employees  and  thousands  of  patients 
have  been  accumulating  evidence  of  the  efficacy 
of  "  Fletcherism"  for  more  than  three  years,  and 
scarce  a  month  passes  without  a  letter  from  Dr. 
Kellogg  to  the  author  containing  new  testimony 
confirming  the  A.  B.  C.  selections  and  sug- 
gestions. 

The  author  has  received  within  the  past  two 
years  more  than  a  thousand  letters  bearing  the 
approval  of  the  writers  with  report  of  benefits 
received  which  seem  almost  miraculous,  and 
these  include  the  leaders  in  many  branches 
of  human  occupation  —  physiologists,  surgeons, 

[■4] 


PREFACE  TO    1906  EDITIONS—  Continued 

medical  practitioners,  artists,  business  men,  lit- 
erary workers,  athletes,  working  men  and  women, 
and  almost  every  degree  of  mental  and  physical 
activity. 

One  of  the  medical  advisers  of  King  Edward, 
of  whom  the  King  once  said  :  "  He  is  a  splendid 
doctor  but  a  poor  courtier,"  follows  the  sugges- 
tions of  these  books  in  prescribing  to  his 
sumptuous  clients. 


C's] 


HISTORY   OF    DEVELOPMENT 


AND 


SUPPORTING   EVIDENCE 


SUMMARY  OF  THE  FOREGOING  PAGES 

BY   AN   EXPERIMENTER   OF   ONE 

MONTH'S   EXPERIENCE 

{Reqtusted  and  given  as  a  test  of  effectiveness) 

The  entire  principle  of  economic  nutrition 
is  simple  and  practical.  It  does  not  prescribe 
that  we  shall  follow  any  special  diet  nor  do  away 
with  any  of  our  meals.  It  simply  requires  you 
to  throw  present  habits  and  conventions  to  the 
winds,  and  for  a  little  time  try  the  experiment 
of  giving  the  matter  of  your  every-day  living 
honest,  intelligent  thought. 

Eat  all  you  crave,  but  do  not  eat  more  than 
this  simply  because  you  have  been  in  the  habit 
of  doing  so.  See  to  it  that  each  morsel  put 
into  your  mouth  is  thoroughly  masticated  and 
mixed  with  the  saliva  before  going  down  into 
the  stomach,  which  is  not  equipped  to  perform 
the  work  which  the  teeth  and  salivary  glands 
were  given  you  for.  The  stomach  will  struggle 
bravely  to  overcome  the  abuse  which  you  heap 
upon  it,  but  in  spite  of  all  it  can  do  to  manage 
hastily  chewed  food,  undigested  portions  remain 
['9] 


The  A.B.'Z,  of  Our  Own  Nutrition 

which  clog  the  intestines  and  interfere  with  the 
healthy  conditions  which  Nature  intended. 

The  appetite  is  given  as  an  indicator  of  what 
the  body  requires.  If  you  crave  potato,  the  sys- 
tem needs  starch,  which  the  saliva  makes  diges- 
tible, but  which  the  acids  of  the  stomach  cannot 
dissolve.  Other  needs  of  the  system  are  simi- 
larly indicated.  Take  the  trouble  of  asking 
your  appetite  the  question,  instead  of  accept- 
ing the  conventional  number  of  courses  simply 
because  they  are  set  before  you.  The  appetite 
will  close  the  valve  when  you  have  eaten  enough, 
if  you  will  give  it  a  chance. 

Suppose  your  time  for  eating  is  limited ;  in 
twenty  minutes  you  could  not  eat  slowly  the 
luncheon  which  you  usually  select.  Then  eat 
that  much  less.  The  amount  of  food  which  you 
can  eat  and  thoroughly  masticate  in  twenty  min- 
utes will  give  you  more  nourishment  and  will 
sustain  you  better  than  twice  the  amount  thrown 
into  the  stomach  in  the  same  manner  in  which 
a  man  usually  packs  a  trunk. 

Why  is  it  that  so  many  men  require  a 
"  bracer  "  at  eleven  o'clock?  Because  they  have 
loaded  their  stomachs  with  a  heavy  breakfast, 
and  instead  of  gaining  nourishment  from  it,  the 
smothered  organ  is  doing  its  best  to  tear  the 
undigested  morsels  to  pieces,  that  they  may 
pass  into  the  intestines  and  prevent  sickness,  or 

[20] 


T^he  A,B,-  Z.  of  Our  Own  Nutrition 

even  death.  The  time  finally  arrives  when  it 
finds  itself  unable  to  do  this,  and  then  comes 
acute  indigestion,  or  something  worse,  and  the 
system  becomes  run  down,  ready  to  receive 
typhoid,  or  any  other  germs  which  happen  to 
come  along. 

Do  you  know  why  griddle-cakes  hurt  you? 
Because  the  syrup,  which  is  cane-sugar,  —  and 
as  such  is  indigestible,  —  is  allowed  to  pass 
through  the  mouth  and  down  into  the  stomach, 
without  being  properly  mixed  with  the  saliva, 
which  makes  it  digestible.  As  soon  as  it  enters 
the  stomach  it  becomes  acid  and  interferes  with 
everything  it  meets.  Had  the  cakes  been  prop- 
erly masticated  and  mixed  with  the  saliva,  the 
cane-sugar  would  have  become  grape-sugar,  and 
in  this  form  it  is  easily  digested. 

Why  is  it  that  stout  people  are  advised  to 
avoid  starchy  foods?  Economic  nutrition  does 
not  advise  this.  Potatoes,  eaten  too  hastily, 
when  not  craved  by  the  appetite,  supply  the 
system  with  a  superabundance  of  starch,  and 
this  is  fat-inducing.  Potatoes  are  supposed 
to  produce  fat;  but  if  your  appetite  craves 
potato,  and  you  properly  masticate  it,  eating 
only  as  much  of  it  as  satisfies  your  appetite,  the 
system  absorbs  it  all,  leaving  nothing  to  pro- 
duce fat.  On  this  same  principle  economic 
nutrition  assures  that  the  same  food,  taken  in 

[21] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

accordance  with  its  requirements,  will  add  to  one 
man's  weight  and  decrease  another's,  simply 
because  proper  care  of  the  stomach  supplies  the 
vital  organs  with  the  necessary  materials  to  form 
each  individual  person  after  the  model  which  Na- 
ture intended  for  him.  If  Nature  intended  him 
to  be  slight,  economic  nutrition  will  not  make 
him  heavy ;  if  Nature  intended  him  to  be  muscu- 
larly  strong  and  heavy,  economic  nutrition  will 
not  reduce  his  weight.  In  each  case  he  will  en- 
joy that  perfect  condition  which  Nature  intended 
him  to  possess  without  fat  encumbrance. 

Did  you  ever  try  to  reason  out  why  it  is 
necessary  for  athletes  to  go  into  training?  Sim- 
ply because,  in  order  to  get  the  best  use  of  their 
strength,  they  are  obliged  to  spend  some  num- 
ber of  weeks  or  months  in  overcoming  false 
conditions  which  they  have  brought  upon  them- 
selves. Any  person  who  hves  in  accordance 
with  the  simple  requirements  of  economic  nutri- 
tion has  nothing  of  this  kind  to  overcome,  but 
is  in  perfect  condition  all  the  time. 

The  requirements  of  economic  nutrition  are 
not  hardships  but  pleasures.  Proper  mastica- 
tion and  insalivation  (mixing  with  saliva),  give 
your  sense  of  taste  far  greater  gastronomic  enjoy- 
ment than  you  have  ever  before  had.  If  you  are 
a  wine  drinker,  try  insalivating  a  little  port  wine ; 
but  it  must  be  good  wine,  for  this  is  a  severe 

["] 


The  A.B,'  Z.  of  Our  Own  Nutrition 

test.  A  sip  will  quench  your  immediate  desire 
and  give  you  more  pleasure  than  a  whole  glass 
gulped  down.  The  professional  tea-taster  does 
this  in  tasting  tea;  he  never  allows  himself  to 
drink  any  tea  at  all,  for  drinking  anything  that 
has  taste  destroys  the  delicacy  of  the  sense 
of  taste.  But  he  will  tell  you  that  he  gets  more 
real  enjoyment  out  of  the  little  he  takes  than 
he  previously  gained  from  drinking  a  larger 
amount.  The  same  thing  applies  to  the  profes- 
sional wine-tasters ;  they  never  drink  any  wine, 
and  yet  they  enjoy  the  taste  of  wine  as  drinkers 
never  can  do.  These  men  adopt  this  method  as 
a  business;  is  their  commercial  advantage  of 
greater  importance  than  your  health  and  happi- 
ness, and  even  life  itself? 

Is  it  not  ridiculous  that  the  average  man  is 
so  ignorant  of  the  engine  which  supplies  him 
with  all  his  activity  and  upon  which  depends 
every  action  of  his  Hfe?  Could  you  tell,  were 
you  asked,  the  particular  need  and  purpose  of 
your  last  meal  and  what  it  is  likely  to  accom- 
plish? Consider  your  body  as  an  engine: 
would  you  accept  yourself  as  a  competent  en- 
gineer on  your  own  examination  and  confes- 
sion? Would  you  employ  a  chauffeur  to  run 
your  automobile  who  knew  as  little  about  its 
mechanism  and  requirements  as  you  do  about 
your  own  stomach?  Yet  which  is  of  greater 
[23l 


T^he  A.B,'Z.  of  Our  Own  Nutrition 

importance?  Were  you  the  owner  of  valuable 
live-stock,  would  you  dare  entrust  their  care 
to  a  farm-hand  or  stableman  who  knew  as  lit- 
tle about  their  proper  feeding  as  you  know 
about  your  own  proper  feeding  or  that  of  your 
children? 

Have  you  ever  stopped  to  think  why  the 
excrements  are  foul  and  odorous?  Simply  be- 
cause undigested  food,  which  should  have  been 
so  masticated  as  to  give  the  body  nourishment, 
is  thrown  off  by  the  stomach  into  the  intestines, 
there  to  decay  and  produce  this  unclean  condi- 
tion. If  the  dead  carcass  of  a  cow  is  lying  in 
the  road,  it  is  removed  before  it  has  an  oppor- 
tunity to  decc^y  and  thus  become  filthy  and 
dangerous.  Yet  ho^v  much  more  safe  it  would 
be  for  the  carcass  to  lie  where  it  was  than  for 
you  to  take  portions  of  it  into  your  intestines 
and  allow  it  to  decay  there  instead  of  in  the 
road?  In  other  words,  food  is  intended  to  be 
eaten  that  nourishment  may  be  gained  from  it, 
and  when  you  only  gain  a  part  of  the  nourish- 
ment, you  prostitute  your  stomach  and  take  tre- 
mendous risks  of  germ  diseases  in  your  body. 

These  facts  are  set  forward  thus  simply  in 
the  hope  that  they  may  impress  the  reader  as 
they  have  impressed  the  writer.  Economic 
nutrition  is  not  a  joke,  is  not  a  fad ;  it  is 
solely  an  appeal   to  self-examination  and  self- 


The  A,B,-Z.  of  Our  Own  Nutrition 

instruction  in  the  most  vital  question  of  all  the 
world,  since  upon  perfect  nutrition  depends  not 
only  health,  but  strength,  mental  acuteness, 
moral  tendencies,  attractability  to  others,  hap- 
piness, and,  in  fact,  life  itself. 


1^5] 


FIRST  SCIENTIFIC  RECOGNITION  OF  THE 
PRINCIPLES  OF  ECONOMIC  NUTRITION 
OUTLINED  IN  "GLUTTON  OR  EPICURE" 

[With  the  exception  of  a  brief  review  of  Glutton  or  Epicure^ 
by  Dr.  Joseph  Blumfield,  of  London,  published  in  The  Lancet, 
no  scientific  or  professional  recognition  of  the  principles  of  an 
economic  nutrition  attained  by  means  of  thorough  buccal 
digestion  was  gained  until  issue  of  the  following  paper  by 
Dr.  Ernest  Van  Someren,  of  Venice,  Italy. 

The  previous  autumn  and  winter  had  been  devoted  to  ex- 
periments by  Dr.  Van  Someren  and  the  writer,  in  co-operation 
with  Dr.  Professor  Leonardi,  for  twelve  years  Professor  of 
Chemistry  in  the  University  of  Pavia,  Italy.  In  the  spring 
and  summer  of  1901  the  field  of  experiments  was  changed  to 
Mendel  Pass,  bei  Bozen,  Slid  Tirol,  Austria,  and  related  to 
endurance  work  in  climbing  mountains  and  bicycle  runs  among 
the  Dolomites. 

Dr.  Van  Someren's  paper  attracted  the  attention  of  Sir 
Michael  Foster,  Professor  of  Physiology  at  the  University  of 
Cambridge,  England,  and  Permanent  Honorary  President  of 
the  International  Congress  of  Physiologists. 

Professor  Foster  entered  into  correspondence  with  Dr.  Van 
Someren,  and  this  was  followed  by  an  invitation  to  Dr. 
Van  Someren  and  the  writer  to  attend  the  Congress  which 
was  to  convene  in  Turin,  Italy,  during  the  month  of  Septem- 
ber following.  At  the  Congress  Dr.  Van  Someren  presented 
a  technical  thesis  on  the  probable  causes  of  the  economy  at- 
tained, and  gave  a  demonstration  of  the  movement  of  his 
Swallowing  Reflex  in  relation  to  food  in  the  process  of  lique- 
faction and  preliminary  digestion  in  the  mouth. 

Following  the  Congress  we  received  an  invitation  to  visit 
Cambridge,  England,  and  submit  to  tests  of  nitrogenous  meas- 
urements in  the  Physiological  Laboratory  of  the  University, 
under  the  direction  of  Dr.  F.  Gowland  Hopkins ;  and  also  to  an 
examination  of  the  bacterial  flora  incident  to  the  nitrogenous 
estimations,  under  the  direction  of  Dr.  George  H.  F.  Nuttall. 

The  report  of  the  experiments  in  the  Chemical-Physiological 
Department  is  given  in  the  "  Note  "  of  Sir  Michael  Foster, 
which  follows  Dr.  Van  Someren's  paper,  but  the  bacterial 
examination  was  not  carried  far  enough  to  warrant  a  scientific 
report,  owing  to  difficulty  of  obtaining,  at  the  time,  sufiicient 
data.  —  Horace  Fletcher.] 


[26] 


WAS   LUIGI   CORNARO   RIGHT? 

A  Paper  read  before  the  Physiological  Section 

OF  the  British  Medical  Association,  August, 

1901,  BY  Ernest  Van  Someren 

Mr.  Presiderit  and  GeJitlemen: 

Being  a  general  practitioner,  it  is  with  some 
trepidation  and  an  apology  that  I  present  myself 
before  this  section.  The  reasons  for  my  doing 
so  are:  First,  that  I  believe  that  a  hitherto 
unsuspected  reflex  in  deglutition  has  come  to 
light  which  has  an  important  bearing  on  health, 
the  prevention  of  disease  and  on  metabolism. 
Second,  that  any  theory  whatever,  based  on  a 
possible  physiological  function,  claiming  to 
diminish,  as  this  does,  the  amount  of  sickness 
and  suffering  now  existent,  should  have  serious 
investigation.  Third,  that  I  desire  to  enlist 
your  skilled  help  in  the  consideration  of  the 
theories  I  have  doubtless  crudely  erected  on 
my  premise. 

According  to  the  "  Encyclopaedia  Britan- 
nica,"     "  Luigi    Cornaro   (1467- 1566)    was   a 

[^7] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

Venetian  nobleman,  famous  for  his  treatises  on  a 
temperate  life.  From  some  dishonesty  on  the  part 
of  his  relatives,  he  was  deprived  of  his  rank  and 
induced  to  retire  to  Padua,  where  he  acquired  the 
experience  in  regard  to  food  and  regimen  which 
he  has  detailed  in  his  work.  In  his  youth  he  lived 
freely,  but  after  a  severe  illness  at  the  age  of 
forty,  he  began  under  medical  advice  gradually 
to  reduce  his  diet.  For  some  time  he  restricted 
himself  to  a  daily  allowance  of  12  ozs.  of  solid 
food  and  14  ozs.  of  wine.  Later  in  life  he  still 
farther  reduced  his  bill  of  fare,  and  he  found 
that  he  could  support  his  hfe  and  strength 
with  no  more  solid  meat  than  an  ^gg  a  day.  So 
much  habituated  did  he  become  to  this  simple 
diet  that  when  he  was  about  seventy  years  of 
age  the  addition,  by  way  of  experiment,  of 
2  ozs.  a  day  had  nearly  proved  fatal.  At  the 
age  of  eighty-three  he  wrote  his  treatise  on  the 
*  Sure  and  Certain  Method  of  Attaining  a  Long 
and  Healthful  Life.'  And  this  work  was  followed 
by  three  others  on  the  same  subject,  composed 
at  the  ages  of  eighty-six,  ninety-one,  and  ninety- 
five,  respectively.  *  They  are  written,'  says  Addi- 
son (*  Spectator,'  No.  195),  *  with  such  a  spirit 
of  cheerfulness,  religion,  and  good  sense,  as  are 
the  natural  concomitants  of  temperance  and 
sobriety.'  He  died  at  the  age  of  ninety-eight." 
Some  say  of  103  ! 

[.8j 


The  A.  B,-  Z.of  Our  Own  Nutrition 

Now,  was  Luigi  Cornaro  right?  Did  he 
make  use  of  a  physiological  process  unknown  to 
us  of  the  value  of  which  he  was  not  cognisant? 
To  live  to  an  advanced  age,  must  we  be  as  tem- 
perate as  he,  reducing  the  quantity  of  our  food 
to  a  minimum  required  by  Nature? 

That  we  all  eat  more  than  we  can  assimilate 
is  unquestionable.  How  can  we  determine  the 
right  quantity?  Instinct  should  guide  us,  but 
an  abnormal  appetite  often  leads  us  astray. 
Nature's  plans  are  perfect  if  her  laws  are  obeyed. 
Disease  follows  disobedience.  Wherein  do  we 
disobey? 

We  live  not  upon  what  we  eat,  but  upon  what 
we  digest;  then  why  should  undigested  food, 
recognisable  as  such,  be  deemed  a  normal 
constituent  of  our  solid  egesta? 

Something  like  the  following  must  be  a  com- 
mon experience  to  general  practitioners,  espe- 
cially to  those  practising  on  the  Continent.  The 
patient  comes  to  see  us  and  volunteers  the  in- 
formation that  he  or  she  has  the  *'  gout," 
"  rheumatic  gout,"  or  "  dyspepsia."  Symptoms 
are  asked  for.  The  case  is  gone  into  carefully 
for  causation.  An  appropriate  diet  and  an 
appropriate  bottle  of  medicine  prescribed.  As 
the  patient  leaves  the  room,  we  may,  or  may 
not,  call  attention  to  the  fact  that  both  teeth 
and  saliva  are  meant  to  be  used.     The  patient 

[^9] 


The  A.B.'Z,  of  Our  Own  Nutrition 

returns,  better,  in  statu  quOyOX  worse.  If  better, 
he  remains  so  while  under  treatment,  and  re- 
lapses when  he  returns  to  ordinary  habits.  If 
unaffected,  or  worse,  we  try  again  and  again, 
until  we  despair,  then  take  or  send  him  to  a 
consultant.  Temporary  benefit,  possibly  owing 
to  renewed  hope,  results;  but  finally  the  un- 
fortunate gets  used  to  his  sufferings  and,  if  he 
can  afford  it,  is  sent  to  join  the  innumerable 
hosts  that  wander  from  one  Bad  to  another, 
all  Europe  over,  trying,  praising,  and  damning 
each  in  turn.  Their  manner  of  living  is,  of 
course,  at  fault.  Nature  never  intended  that 
man  should  be  perpetually  on  a  special  diet  and 
hugging  a  bottle  of  medicine,  nor  did  she  ordain 
that  he  should  go  wandering  over  the  map  of 
Europe  drinking  purgative  and  other  waters. 

Though  early  yet  to  speak  with  certain  voice, 
it  would  seem  that  we  are  provided  with  a  Guard, 
reliance  on  which  protects  us  from  the  results  of 
mal-nutrition.  There  seems  to  be  placed  in  the 
fauces  and  the  back  of  the  mouth  a  Monitor  to 
warn  us  what  we  ought  to  swallow  and  when  we 
ought  to  swallow  it.  The  good  offices  of  this 
Monitor  we  have  suppressed  by  habits  of  too 
rapid  eating,  acquired  in  infancy  or  youth. 

Last  November  my  attention  was  called  by 
Mr.  Horace  Fletcher,  an  American  author  living 
in   Venice,   to   the    discovery   in  himself  of  a 

[30] 


The  A.B.'Z.ofOur  Own  Nutrition 

curious  inability  to  swallow,  and  a  closing  of  the 
throat  against  food,  unless  it  had  been  com- 
pletely masticated.  My  informant  stated  that 
he  noticed  this  peculiarity  after  he  had  begun  to 
excessively  insalivate  his  food,  both  liquid  and 
solid,  until  all  its  original  taste  had  been  re- 
moved from  it.  Any  tasteless  residue  in  the 
•  mouth,  being  refused  by  the  fauces,  required  a 
forced  muscular  effort  to  swallow.  He  further 
told  me  that  since  adopting  this  method  of  eat- 
ing he  had  been  cured  of  two  maladies,  adjudged 
chronic,  the  suffering  from  which  rendered  him 
ineligible  for  Life  Insurance.  His  weight  now 
became  reduced  from  205  lbs.  to  165  lbs.  He 
had  practised  no  abstemiousness,  had  indulged 
his  appetite,  both  as  to  selection  and  to  quan- 
tity, without  restraint,  and  for  the  last  three 
years  had  enjoyed  perfect  health. 

After  his  cure,  he  was  accepted  without  dif- 
ficulty for  insurance,  the  last  examination  find- 
ing him  an  unusually  healthy  subject  for  his  age. 
Having  leisure,  he  had  spent  three  years  in 
investigating  the  cause  of  his  cure,  had  pursued 
experiments  upon  others,  and  had  extended  his 
inquiries,  both  in  America  and  Europe,  until  our 
meeting  in  Venice.  He  had  also  published  a 
statement  and  inquiry  in  book  form,  entitled 
"  Glutton  or  Epicure,"  which  had  been  reviewed 
by  the  "Lancet." 

[31] 


T^he  A.  B,-Z.of  Our  Own  Nutrition 

For  nearly  a  year  I  also  had  been  experi- 
menting on  myself  and  others  with  various  diets, 
and  was  ready  to  believe  that  in  the  manner  of 
taking  food  and  not  altogether  in  its  varying 
matter  lay  perhaps  its  protean  effects  on  our 
system.  I  at  once  adopted  the  same  method  of 
eating.  At  the  end  of  six  weeks,  I  noticed  that 
not  only  did  the  fauces  refuse  to  allow  of  the 
passage  of  imperfectly  prepared  food,  but  that 
such  food  was  returned  from  the  back  to  the 
front  of  the  mouth  by  an  involuntary,  though 
eventually  controllable,  muscular  effort  taking 
place  in  the  reverse  direction  to  that  occurring  at 
the  inception  of  deglutition. 

What  actually  happens  is  this  :  Food,  as  it  is 
masticated,  slowly  passes  to  the  back  of  the 
mouth,  and  collects  in  the  glosso-epiglottidean 
folds,  where  it  remains  in  contact  with  the 
mucous  membrane  containing  the  sensory  end- 
organs  of  taste.  If  it  be  properly  reduced  by  the 
saliva  it  is  allowed  to  pass  the  fauces,  —  a  truly 
involuntary  act  of  deglutition  occurring.  Let 
the  food,  however,  be  too  rapidly  passed  back 
to  these  folds,  2.^.,  before  complete  reduction  takes 
place,  and  the  reflex  muscular  movement  above 
referred  to  occurs.  The  process  of  this  reflex 
is  as  follows :  The  tip  of  the  tongue  is  involun- 
tarily fixed  at  the  backs  and  bases  of  the  lower 
central  incisor  teeth  by  the  anterior  fibres  of 

[30 


T^he  A.B.-Z.  of  Our  Own  Nutrition 

the  geniohyoglossi  muscles.  With  this  fixed 
point  as  fulcrum,  the  lower  and  middle  fibres  of 
these  muscles,  aided  by  those  of  the  stylohyoid 
and  styloglossi  muscles  raise  the  hyoid  bone, 
straighten  out  the  glosso-epiglottidean  folds, 
passing  their  contents  forward,  by  the  fauces, 
the  opening  of  which  is  closed  by  approxi- 
mation of  its  pillars  and  contraction  of  the 
superior  constrictor.  The  tongue,  arched  pos- 
tero-anteriorly  by  the  geniohyoglossi,  palato, 
and  styloglossi  muscles,  laterally,  by  its  own 
intrinsic  muscles,  is  approximated  to  the  fauces, 
soft  and  hard  palates  in  turn,  and  thus,  the 
late  contents  of  the  glosso-epiglottidean  folds 
are  returned  to  the  front  of  the  mouth  for 
further  reduction  by  the  saliva  preparatory  to 
deglutition. 

The  word  reduction  is  used  for  the  reason 
that  all  foods  tested,  without  exception,  give  an 
acid  reaction  to  litmus,  when  served  at  table. 
The  reflex  muscular  movement  occurs  in  the 
writer's  case  from  five  to  ten  times  during  the 
mastication  of  each  mouthful  of  food,  accord- 
ing to  its  quantity  and  its  degree  of  sapidity. 
As  often  as  it  recurs,  the  returned  food  con- 
tinues to  give  an  acid  reaction,  while  food 
allowed  to  pass  the  fauces  is  alkaline. 

Saliva,  flowing  in  response  to  the  stimulation 
of  taste,  seems  more  alkaline  than  that  secreted 
3  [33] 


7 he  A.B,'Z.  of  Our  Own  Nutrition 

in  answer  to  mechanical  tasteless  stimulation. 
It  is  found  that  the  removal  of  original  taste 
from  any  given  bolus  of  food  coincides  with 
cessation  of  salivary  flow  and  complete  alkaline 
reduction.  The  fibre  of  meat,  gristle,  con- 
nective tissue,  the  husk  of  coarse  bread  and 
cellulose  of  vegetables  are  carefully  separated 
by  the  tongue  and  buccal  muscles  and  rejected 
by  the  fauces.  To  swallow  any  of  these  ne- 
cessitates a  forced  muscular  effort,  which  is 
abnormal. 

Adult  man  was  not  originally  intended  to 
take  his  nourishment  in  a  Hquid  form,  conse- 
quently all  liquids  having  taste,  such  as  soup, 
milk,  tea,  coffee,  cocoa,  and  the  various  forms 
of  alcohol,  must  be  treated  as  sapid  solids  and 
insalivated  by  holding  them  in  the  mouth, 
moving  the  tongue  gently,  with  straight  up  and 
down  masticatory  movements,  until  their  taste 
be  removed.  Water,  not  having  taste,  needs 
no  insalivation  and  is  readily  accepted  by  the 
fauces. 

In  explanation  of  the  phenomenon  described, 
the  following  theory  is  advanced :  The  fauces 
back  of  the  tongue,  epiglottis,  in  short,  those 
mucous  surfaces  in  which  are  placed  the  sensory 
end-organs  of  taste  and  "  taste-buds  "  (the  dis- 
tribution of  which,  by  the  way,  has  yet  to  be  ex- 
plained), that  these  surfaces,  readily  becoming 
[34] 


The  A,B,'Z.  of  Our  Own  Nutrition 

accustomed  to  an  alkaline  contact  by  ex- 
cessive insalivation  and  consequent  complete 
alkaline  reduction  of  the  food,  afterwards  resent 
an  acid  contact  and  express  their  resentment 
by  throwing  off  the  cause  of  offence  by  the 
muscles  underlying  them. 

This  phenomenon  must  not  be  confused  with 
the  cases  of  rumination  and  regurgitation,  which 
from  time  to  time  are  recorded.  The  food  in 
this  case  is  not  swallowed,  nor  does  it  pass  any 
point  from  which  it  can  be  regurgitated.  Eighty- 
one  individuals  of  different  nationalities  and  from 
several  classes  of  society  whom  we  have  studied 
are  now  in  conscious  possession  of  their  reflexes. 
These  seem  readily  educated  back  to  normal 
functions  by  all  who  seriously  and  patiently 
adopt  the  habit  of  what  seems  only  at  first  to 
be  excessive  insalivation. 

The  dictum  "  bite  your  food  well "  that  we 
so  often  use,  has  no  meaning  to  those  suffer- 
ing from  the  results  of  mal-assimilation  and 
mal-nutrition,  especially  should  they  have  few 
or  no  teeth  of  their  own.  I  make  so  bold  as  to 
state  that  dyspepsia  et  morbi  hujus generis  omnis 
will  cease  to  exist  if  patients  be  persuaded  to 
bite  their  food  until  its  original  taste  disappears, 
and  it  is  carried  away  by  involuntary  deglutition. 
The  important  point  of  the  whole  question 
seems  to  be  this  alkaline  reduction  of  acid  food 

[35] 


The  A.B.-Z,  of  Our  Own  Nutrition 

before  it  passes  on  to  meet  subsequent  digestive 
processes  elsewhere,  which  then  become  alter- 
nately acid  and  alkaline. 

In  the  first  few  months  of  infant  life,  when 
saliva  is  not  secreted.  Nature  ordains  that 
mammary  secretion  be  alkaHne.  With  the 
eruption  of  teeth  come  an  abundant  flow  of 
saHva  and  a  synchronous  infantile  capacity  for 
managing  other  foods.  This  flow  of  saliva 
depends  on  a  thorough  demand  and  use  to 
maintain  its  generous  supply.  It  is  just  at  this 
time  that  children  learn  to  bolt  their  food,  — 
the  demand  fails,  with  a  consequent  detriment  to 
the  salivary  glands,  digestive  processes,  and  the 
system  generally. 

A,  B,  C,  and  D  were  placed  on  an  absolute 
milk  diet.  A  drank  his  milk  in  the  ordinary 
way,  and  at  the  end  of  three  days  begged  to 
discontinue  the  experiment  owing  to  disgust 
at  the  monotony  of  the  diet.  B,  C,  and  D 
continued  the  experiment  for  seventeen  days, 
insalivating  the  milk,  but  to  a  varying  extent,  B 
the  least  and  D  the  most.  Though  D  took 
most  milk,  he  excreted  least  solid  egesta,  C 
excreting  less  than  B.  Can  one  infer  that  in- 
creased insalivation  of  a  non-starchy  food  insured 
its  better  digestion  and  assimilation?  Each  sub- 
ject took  as  much  milk  only  as  his  appetite 
demanded,    D    taking  the    most,   which    never 

[36] 


The  A,B.-Z,  of  Our  Own  Nutrition 

exceeded  two  litres  daily.  The  weights  of  the 
subjects  after  the  usual  sudden  drop  of  the  first 
three  days  remained  remarkably  even  until  the 
end  of  the  experiment.  B,  C,  and  D  all  relished 
the  diet,  and  it  satisfied  the  requirements  of  their 
appetites,  but  they  experienced  an  increasing 
monotony. 

As  long  ago  as  the  seventeenth  century, 
before  the  transformation  of  matter  into  energy 
by  the  animal  organism,  known  as  Metabolism, 
was  understood,  the  fact  was  recognised  that  by 
the  lungs,  kidneys,  skin,  and  intestines,  sub- 
stances no  longer  useful  to  the  organism  were 
eliminated,  the  retention  of  which  proved 
harmful.  The  nature  of  these  substances 
was  unknown,  but  it  was  noted  that  how- 
ever much  the  food  was  increased  the  weight 
of  the  body  remained  the  same.  In  other  words, 
a  state  of  complete  nutritive  equilibrium  was 
maintained. 

The  following  table  contains  the  resume  of  two 
experiments  in  which  a  state  of  complete  nutri- 
tive equilibrium  was  maintained  by  individuals 
of  about  the  same  weight,  on  widely  different 
quantities  of  food  similar  in  quality.  The  sub- 
jects of  the  experiments  were  a  laboratory  assist- 
ant of  Dr.  Snyder,  of  the  U.  S.  Department  of 
Agriculture,  and  the  writer.  The  experiment 
of  the  former  was  made  primarily  to  show  the 

[37] 


The  A,  B,-Z,of  Our  Own  Nutrition 

relative  digestibility  of   the  several  articles  of 
diet,  potatoes,  eggs,  milk,  and  cream : 


Dr.  Snyder's 

Experiment. 

Writer's  Experiment. 

Published  in  Bulletin  43 

Age  of  subject .... 

22  years 
A\  days 

30  years 

Duration  of  experiment 

5  days 

Number  of  meals  .     .     . 

13 

10 

Weight  at  beginning 

62.5  kilos. 

57.3  kilos. 

Weight  at  end  .... 

62.6  kilos. 

57.5  kilos. 

Potatoes  (daily  average) 

1587.6    grammes 

159.4  grammes 

Eggs  (daily  average) 

41 1.08  grammes 

124.7  grammes 

Milk  (daily  average) 

710  c.c. 

710  c.c. 

Cream  (daily  average)   . 

237  c.c. 

237  c.c. 

Daily  urine 

1 1 08  grammes 

1098  grammes 

Daily  fasces      .... 

204  grammes 

18.9  grammes 

The  daily  diet  of  Dr.  Snyder's  subject  con- 
sisted of  three  and  one-half  pounds  of  potatoes, 
eight  eggs,  a  pint  and  a  half  of  milk,  and  half 
a  pint  of  cream.  The  writer's  diet  of  twelve 
ounces  of  solid  food  (like  Luigi  Cornaro)  con- 
sisted of  three  eggs,  the  remainder  of  the  twelve 
ounces  in  potatoes,  and  an  equal  quantity  of 
similar  liquid  food  to  that  taken  by  Dr.  Snyder's 
subject.  The  exercise  of  the  laboratory  assist- 
ant comprised  his  daily  routine  of  laboratory 
work,  while  that  of  the  writer  consisted  of  six 
sets  of  tennis,  or  an  hour  and  a  half  on  horse- 
back, with  an  hour  to  an  hour  and  a  half's  walk 
or  climb  daily,  in  addition  to  much  reading  and 
writing. 

In  each  case  complete  nutritive  equilibrium 
was  maintained,  although  the  author  subsisted 

[38] 


The  A,B.-Z.  of  Our  Own  Nutrition 

on  three-seventeenths  of  the  solid  food  taken 
by  the  other  subject. 

Again,  cannot  one  infer  that  better  assimi- 
lation and  less  waste  resulted  from  the  better 
preparation  of  the  smaller  quantity  of  food  by 
insalivation?  Surely,  too,  there  must  be  less 
daily  strain  on  the  intestinal  canal,  and  body 
generally,  in  getting  rid  of  18.9  grammes  of 
inoffensive  dry  waste,  than  in  getting  rid  of  204 
grammes  of  humid,  decomposing,  and  offensive 
matter. 

"  Considerable  importance  has  been  attached 
to  the  normal  action  of  the  bacteria  in  the 
intestines ;  and  it  has  even  been  supposed  that 
the  presence  of  bacteria  is  essential  to  life. 
Such  a  view  has  recently  been  shown  to  be 
erroneous  by  an  elaborate  and  painstaking  re- 
search carried  out  by  Nuttall  and  Thierfelder, 
who  obtained  ripe  foetal  guinea-pigs  by  means 
of  Caesarean  section  carried  out  under  strict 
antiseptic  precautions.  They  introduced  the 
animals  immediately  into  an  aseptic  chamber 
through  which  a  current  of  filtered  air  wa3 
aspirated,  and  fed  them  hourly  on  sterilis-i 
milk  day  and  night  for  over  eight  days. 

"The  animals  lived,  and  throve,  and  f-" 
creased  as  much  in  weight  as  healthy  normiii 
animals  subjected  to  a  similar  diet  for  the  pur- 
pose   of  controlling   the   results.     Microscopic 

[39] 


The  A,B,-  Z.  of  Our  Own  Nutrition 

examination  at  the  end  of  the  experiment 
showed  that  the  alimentary  canal  contained  no 
bacteria  of  any  kind,  nor  could  cultures  of  any 
kind  be  obtained  from  it. 

**  The  same  authors,  in  a  subsequent  paper, 
described  the  extension  of  their  research  to 
vegetable  food.  This  was  also  digested  in  the 
absence  of  bacteria.  Under  such  conditions  cel- 
lulose was  not  attacked.  Hence  they  consider 
that  the  chief  function  of  this  material  is  to  give 
bulk  and  proper  consistency  to  the  food  so  as 
to  suit  the  conditions  of  herbiverous  digestion." 
(Schafer's  "  Text-Book  of  Physiology,"  vol  i. 
p.  465.) 

Now,  inasmuch  as  bacterial  digestion  has  no 
place  in  the  animal  economy,  surely  it  can  only 
occur  at  the  expense  of  the  organism? 

Can  micro-organic  action  take  place  in  the 
intestines  without  the  production  of  toxins  and 
the  consequent  absorption  of  these  toxins  into 
the  blood? 

We  know  that  the  metabolism  of  a  cell  is 
determined  by  the  general  physical  environ- 
ment of  the  whole  organism,  by  supplies  of 
oxygen  and  water,  on  nervous  impulses,  and, 
what  chiefly  concerns  this  argument,  on  the  na- 
ture and  amount  of  the  pabulum  supplied  to  it. 
This  pabulum  is  derived  from  the  alimentary 
canal. 

[40] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

Are  not  even  those  of  us  who  may-be  enjoy- 
ing seemingly  the  best  of  health  supplying  to 
our  tissues  pabulum  containing  mild  toxins,  thus 
causing  an  increased  katabolic  action  to  occur  in 
each  individual  cell  of  our  bodies? 

Are  not  the  blood  elements,  floating  in 
a  plasma  containing  such  toxins,  rendered 
resistent,  weaker,  less  capable  of  fulfilling 
their  functions  as  carriers  and  combatants  of 
disease? 

Are  not  their  and  our  lives,  in  consequence, 
more  painful  and  shorter  than  they  need  be? 

Would  not  the  elimination  of  these  toxins 
render  us  less  liable  to  disease?  And  is  not 
their  presence  an  important  element  in  predis- 
position to  disease? 

When  this  reflex  is  restored  micro-organisms 
get  no  further  than  the  stomach.  They  are  de- 
stroyed there  by  the  acid  gastric  juices,  then 
only  stimulated  to  their  full  and  normal  secre- 
tion by  the  presence  of  a  sufficiency  of  alkaline 
substance.  Undigested  matter  having  been 
eliminated,  micro-organisms,  still  existing  in  the 
intestines,  deprived  of  their  means  of  subsis- 
tence, decrease,  and,  in  time,  may  cease  to 
exist.  The  body  no  longer  absorbs  the  toxins 
these  produced.  To  this  fact  may  be  ascribed 
the  increase  of  mental  energy,  the  general  physi- 
cal betterment,  the  cessation  of  morbid  cravings 
[41] 


The  A,B.'  Z.  of  Our  Own  Nutrition 

for  food  and  drink  and    of  those  of  a  sexual 
nature,  which  are  noticed  and  experienced. 

What  has  just  been  stated  is  based  not  en- 
tirely on  experimental  evidence  but  somewhat 
upon  inference.  The  inference  seems  justified 
because  the  excreta,  more  especially  of  the 
intestines,  but  also  of  the  kidneys  and  skin, 
become  almost  odourless  and  entirely  inoffen- 
sive. The  solid  egesta  are  voided  thickly  cov- 
ered with  mucus,  leaving  the  end  of  the  bowel 
dry  and  clean.  The  sense  of  cleanliness  can 
only  then  be  appreciated  to  the  full,  for  it  is 
internal  as  well  external.  Flatus  is  no  longer 
produced.  The  urine  is  inoffensive  and  seems 
to  be  materially  changed  in  quality,  as  shown 
by  chemical  analysis.  Uric  acid,  the  chlorides, 
and,  more  markedly,  aromatic  sulphates  are  re- 
duced in  quantity. 

Owing  to  deliberation  in  eating,  necessitated 
by  this  new  habit,  satiety  occurs  on  the  ingestion 
of  considerably  less  food.  By  carefully  studying 
one's  self  I  believe  it  possible  to  cultivate  an  in- 
stinct which  will  regulate  not  only  the  quantity 
but  the  quality  of  food  that  the  body  may  need, 
and  that  in  the  normal  health  of  a  full-grown 
body,  no  more  food  either  in  quantity  or  quality 
should  be  supplied  than  suffices  to  supply  diur- 
nal waste.  Any  excess  must  result  in  patho- 
logical processes. 

[4^] 


The  A,B,-Z.  of  Our  Own  Nutrition 

Although  there  results  enhanced  pleasure  in 
the  taking  of  all  foods,  rich  and  simple,  and  es- 
pecially in  the  appreciation  of  good  wines,  the 
quantities  of  these  foods  and  beverages  that  suf- 
fice to  fully  satisfy  the  appetite  are  much  smaller 
than  before,  while  there  is  a  marked  preference 
for  the  simpler  kinds  of  food.  The  writer  now 
can  imagine  no  more  pleasurable  meal  than 
one  consisting  of  good  brown  bread,  eggs,  but- 
ter, cheese,  and  cream.  These,  with  fresh  vege- 
tables and  a  very  little  fruit,  form  his  staple 
diet.  This  tendency  and  preference  for  simple 
foods  is  the  general  experience  among  those  who 
have  recovered  their  reflexes  of  deglutition. 

Following  on  the  ingestion  of  a  lessened 
quantity  of  food  and  on  its  better  assimilation, 
there  is  less  waste,  the  egesta  are  voided  less 
frequently,  sometimes  only  once  in  five  to  eight 
days. 

The  lower  bowel  is  not  the  reservoir  it  for- 
merly was.  So  haemorrhoids  cease  from  trou- 
bling and  constipation  cannot  exist.  For  this 
same  reason  the  body,  at  the  beginning  of  the 
practice,  commences  to  approximate  to  its  nor- 
mal weight,  increasing  or  decreasing  as  the 
individual's  environment  demands. 

A  few  more  words  only  need  be  said.  It  has 
been  easy  to  state  the  results  of  experiments  and 
observations:    but    the   acquiring   of  this   new 

[43] 


The  A,  B.-Z.of  Our  Own  Nutrition 

reflex,  while  pursuing  daily  occupations,  is  not 
easy,  and  needs  more  than  a  little  patience  and 
much  serious  thought.  The  habits  of  a  lifetime 
cannot  be  changed  in  a  few  days  or  weeks.  The 
shortest  time  in  which  the  reflex  has  been  re- 
established is  four  weeks,  and  this  only  by  avoid- 
ing conversation  at  meal-time  and  concentrating 
the  attention  on  keeping  the  food  in  the  mouth 
until  complete  alkaline  reduction  has  taken  place 
and  sapidity  has  disappeared. 

In  closing  I  wish  to  maintain  as  a  fact,  gen- 
tlemen, of  the  truth  of  which  you  will  only  be 
convinced  by  actual  experience,  that  by  the 
restoration  of  this  reflex  and  in  complete  de- 
pendence on  its  use,  there  lies  true  health,  the 
establishment  of  a  condition  of  stable  nutrition 
and  the  possible  abrogation  of  two  great  predis- 
posing factors  of  disease,  mal-assimilation  and 
mal-nutrition.  Unless  there  be  among  you,  as 
in  the  "  Cities  of  the  Plain,"  a  parlous  minority 
who  possess  this  reflex  and  take  your  food  as 
you  ought,  none  of  you  are  in  the  enjoyment 
of  such  health  as  you  might  have.  A  like  pun- 
ishment will  be  meted  out  to  you  as  was  visited 
on  those  cities,  for  you  will  all  be  consumed 
long  before  your  day  by  the  unnecessary  com- 
bustion in  your  bodies  caused  by  the  circulation 
in  them  of  toxins,  the  product  of  undigested  and 
decomposing  food. 

[44] 


'The  A.B.-Z.  of  Our  Own  Nutrition 

The  writer,  bearing  in  mind  the  warning  sug- 
gested by  the  Frenchman  whose  donkey  died  as 
soon  as  he  had  reduced  his  food  to  a  single  wisp 
of  straw,  finds  that  he  is  taking  less  and  less 
food.  While  his  mind  is  open  as  to  his  arriv- 
ing at  the  final  diet  of  Luigi  Cornaro,  yet  it  is 
easily  conceivable  that  living  a  similar  life  of 
retirement  in  a  placid  environment,  it  would  be 
quite  possible  to  do  as  he  did.  Hence  the 
title  of  this  paper  and  the  queries  at  the 
commencement. 

The  objects  in  publishing  and  distributing 
this  paper  are  twofold:  to  make  the  subject 
as  widely  known  as  possible,  and  to  solicit  the 
aid  of  colleagues  in  investigating  it  more  fully. 

There  is  ready  at  the  service  of  the  general 
practitioner  an  important  and  potential  thera- 
peutic agent  in  the  saliva  of  his  patients  and  in 
the  use  adfinem  of  their  salivary  digestions. 

By  any  chance  should  readers  of  this  paper 
wish  to  ask  any  questions,  the  writer  will  be 
happy  to  communicate  with  them. 

183,  Calle  del  Capello  Nero, 

Piazza  San  Marco, 

Venice,  Italy. 

Editor's  notes,  (i)  Confirmatory  evidence  of 
the  correctness  of  the  deductions  made  in  this 
paper  has  begun  to  come  in  from  many  profes- 
sional sources  and  notably  from  a  famous  child 

[45] 


The  A,B,-Z,  of  Our  Own  Nutrition 

specialist  who  avers  that  children  would  follow 
the  natural  requirements  in  eating  were  it  not  for 
artificial  food,  bad  example,  and  bad  teaching. 

(2)  In  a  report  of  a  paper  read  before  the 
Sociit^  de  Biologie^  Paris,  France,  March  15th, 
1902,  by  M.  Max  Marckwald,  of  Kreuznach, 
"  On  Digestion  of  Milk  in  the  Stomach 
OF  Full-grown  Dogs,"  the  following  appears : 
"  Hence  these  experiments  confirm  those  of 
Horace  Fletcher  and  Ernest  H.  Van  Someren 
on  the  importance  of  prolonged  mastication " 
(translation).  Referring,  as  the  latter  statement 
does,  to  mastication  (insalivation)  of  liquid,  it 
gives  an  important  suggestion  relative  to  some 
probable  causes  of  uncertain  or  defective  diges- 
tion in  human  nutrition. 


r46] 


THE   CAMBRIDGE   TESTS 

[In  connection  with  a  report  of  the  Cambridge  Elxamination 
the  writer  wishes  to  acknowledge  the  interest  and  assistance  of 
Dr.  Francis  Gowland  Hopkins,  head  of  the  Physiological- 
Chemical  Department  of  the  Physiological  Laboratory  of  the 
University;  Dr.  George  H.  F.  Nuttall,  in  charge  of  the  Bac- 
teriological Section  of  the  Pathological  Laboratory ;  Mr.  Sid- 
ney W.  Cole,  Mr.  Robert  Barrett,  and  Dr.  Hubert  Higgins, 
both  for  practical  work  in  the  laboratory  and  in  serving  as  test- 
subjects.  To  Dr.  Higgins  so  much  is  due  that  it  is  difficult  to 
measure.  Since  our  first  meeting  in  Cambridge,  Dr.  Higgins 
has  been  unremitting  in  his  study  of  the  subject  and  in  con- 
sideration of  its  application  to  human  betterment.  Having 
the  altruistic  temperament  inborn  and  not  yet  smothered  by 
disappointment,  the  good  doctor  has  consecrated  himself  to 
the  service  of  poorer  humanity,  and  his  inspiration  in  so  good 
a  cause  is  wonderful  motive  power  behind  the  native  desire  to 
do  good.  The  statement  of  Dr.  Higgins'  experiences  in  pur- 
suit of  an  Economic  Nutrition  is  given  in  his  own  manner  in 
the  new  edition  of  Glutton  or  Epicure,  which  is  being  published 
coincidently  with  this  volume  in  the  A.  B.  C.  Life  Series. 

At  the  time  we  were  in  Cambridge,  Dr.  Hopkins  and  Mr. 
Cole  had  just  published  their  paper  in  ih&  Journal  oj  Physiology 
(English),  describing  their  isolation  of  the  tryptophane  element 
of  the  proteid  molecule  which  had  eluded  chemists  from  the 
beginning.  In  tryptophane  they  found  embodied  the  odour- 
ous  indol  and  skatol  which  appear  so  offensively  in  the  putrid 
decomposition  of  proteid.  In  the  excreta  of  the  test-subjects 
in  our  Economic-Nutrition-Inquiry  these  malodorous  sub- 
stances did  not  appear,  and  hence  another  question  is  opened 
up  to  investigation  relative  to  the  putridity  of  human  excre- 
ment under  ordinary  conditions  of  carelessness,  and  the 
".bsence  of  putridity  in  the  case  of  nutrition  accomplished 
by  aid  of  thorough  buccal  treatment  of  food  preparatory  to 
digestion. 

It  is  a  matter  of  interest,  relative  to  the  patience  required  in 
science,  to  state  that  Dr.  Hopkins  and  Mr.  Cole  were  fourteen 
months  searching  for  the  fugitive  tryptophane  element  after 
they  received  their  first  clew  to  its  whereabouts.  When 
isolated,  tryptophane  masses  in  a  substance  having  the  ap- 
pearance of  silver,  but  not  the  solidity  of  that  metal.  — 
Horace  Fletcher.] 


[47] 


EXPERIMENTS   UPON   HUMAN 
NUTRITION 

Note  by  Sir  Michael  Foster,  K.C.B.,  M.P.,  F.R.S. 

In  1 90 1  Dr.  Ernest  Van  Someren  submitted 
to  the  British  Medical  Association,  and  after- 
wards to  the  Congress  of  Physiologists  at  Turin, 
an  account  of  some  experiments  initiated  by 
Mr.  Horace  Fletcher.  These  experiments  went 
to  show  that  the  processes  of  bodily  nutrition 
are  very  profoundly  affected  by  the  preliminary 
treatment  of  the  foodstuffs  in  the  mouth,  and 
indicated  that  great  advantages  follow  from  the 
adoption  of  certain  methods  in  eating.  The 
essentials  of  these  special  methods,  stated  briefly 
and  without  regard  to  certain  important  theo- 
retical considerations  discussed  by  Dr.  Van 
Someren,  consist  of  a  specially  prolonged  mas- 
tication which  is  necessarily  associated  with  an 
insalivation  of  the  foodstuffs  much  more  thorough 
than  is  obtained  with  ordinary  habits. 

The  results  brought  to  hght  by  the  prelim- 
inary experimental  trials  went  to  show  that 
such  treatment  of  the  food  has  a  most  important 
[43] 


T^he  A.B.'Z.  of  Our  Own  Nutrition 

effect  upon  the  economy  of  the  body,  involving, 
in  the  first  place,  a  very  notable  reduction  in  the 
amount  of  food  —  and  especially  of  proteid  food 
—  necessary  to  maintain  complete  efficiency. 

In  the  second  place  this  treatment  produced, 
in  the  experience  of  its  originators,  an  increase 
in  the  subjective  and  objective  well-being  of 
those  who  practise  it,  and,  as  they  beheve,  in 
their  power  of  resistance  to  the  inroads  of 
disease.  These  secondary  effects  may  indeed 
be  almost  assumed  as  a  corollary  of  the  first 
mentioned ;  because  there  can  be  little  doubt 
that  the  ingestion  of  food  —  and  perhaps  espe- 
cially of  proteid  food  —  in  excess  of  what  is, 
under  the  best  conditions,  sufficient  for  main- 
tenance and  activity,  can  only  be  deleterious  to 
the  organism,  clogging  it  with  waste  products 
which  may  at  times  be  of  a  directly  toxic 
nature. 

In  the  autumn  of  1901  Mr.  Fletcher  and  Dr. 
Van  Someren  came  to  Cambridge  with  the 
intention  of  having  the  matter  more  closely  in- 
quired into,  with  the  assistance  of  physiological 
experts.  The  matter  evoked  considerable  in- 
terest in  Cambridge,  and  observations  were 
made  not  only  upon  those  more  immediately 
interested,  but  upon  other  individuals,  some 
of  whom  were  themselves  medical  men  and 
trained  observers. 

4  [49] 


The  A.B,-Z,  of  Our  Own  Nutrition 

Certain  facts  were  established  by  these  ob- 
servations, which,  however,  are  to  be  looked 
upon  as  still  of  a  prehminary  nature.  The 
adoption  of  the  habit  of  thorough  insalivation 
of  the  food  was  found  in  a  consensus  of  opinion 
to  have  an  immediate  and  very  striking  effect 
upon  appetite,  making  this  more  discriminating, 
and  leading  to  the  choice  of  a  simple  dietary, 
and  in  particular  reducing  the  craving  for  flesh 
food.  The  appetite,  too,  is  beyond  all  question 
fully  satisfied  with  a  dietary  considerably  less  in 
amount  than  with  ordinary  habits  is  demanded. 

Numerical  data  were  obtained  in  several 
cases,  but  it  is  not  proposed  to  deal  with  these 
in  detail  here,  as  they  need  the  supplementary 
study  which  will  be  shortly  referred  to. 

In  two  individuals  who  pushed  the  method  to 
its  limits  it  was  found  that  complete  bodily 
efficiency  was  maintained  for  some  weeks  upon 
a  dietary  which  had  a  total  energy  value  of  less 
than  one-half  of  that  usually  taken,  and  com- 
prised little  more  than  one-third  of  the  proteid 
consumed  by  the  average  man. 

It  may  be  doubted  if  continued  efficiency 
could  be  maintained  with  such  low  values  as 
these,  and  very  prolonged  observations  would 
be  necessary  to  establish  the  facts.  But  all 
subjects  of  the  experiments  who  applied  the 
principles  intelligently  agreed  in  finding  a  very 
[so] 


T^he  A.B,-  Z.  of  Our  Own  Nutrition 

marked  reduction  in  their  needs,  and  experi- 
enced an  increase  in  their  sense  of  well-being 
and  an  increase  in  their  working  powers. 

One  fact,  fully  confirmed  by  the  Cambridge 
observations,  consists  in  the  effect  of  the  special 
habits  described  upon  the  waste  products  of  the 
bowel.  These  are  greatly  reduced  in  amount, 
as  might  be  expected ;  but  they  are  also  markedly 
changed  in  character,  becoming  odourless  and 
inoffensive,  and  assuming  a  condition  which 
suggests  that  the  intestine  is  in  a  healthier  and 
more  aseptic  condition  than  is  the  case  under 
ordinary  circumstances. 

Although  the  experiments  hitherto  made  are, 
as  already  stated,  only  preliminary  in  nature 
and  limited  in  scope,  they  establish  beyond  all 
question  that  a  full  and  careful  study  of  the 
matter  is  urgently  called  for. 

For  this  fuller  study  the  Cambridge  labora- 
tories do  not  possess  at  present  either  the 
necessary  equipment  or  the  funds  to  provide  it. 
For  the  detailed  study  of  the  physical  efficiency 
of  a  man  under  varying  conditions,  elaborate 
and  expensive  apparatus  is  required ;  and  the 
advantages  claimed  for  the  special  treatment  of 
the  food  just  discussed  can  only  be  fully  tested 
by  prolonged  and  laborious  experiments  calling 
for  a  considerable  staff  of  workers. 

It  is  of  great  importance  that  the  mind  of  the 


The  A.B.'Z,  of  Our  Own  Nutrition 

lay  public  should  be  disabused  of  the  idea  that 
medical  science  is  possessed  of  final  information 
concerning  questions  of  nutrition.  This  is  very 
far  indeed  from  being  the  case.  Human  nutri- 
tion involves  highly  complex  factors,  and  the 
scientific  basis  for  our  knowledge  of  the  sub- 
ject is  but  small;  where  questions  of  diet  are 
concerned,  medical  teaching,  no  less  than 
popular  practice,  is  to  a  great  extent  based 
upon  empiricism. 

But  the  scientific  and  social  importance  of  the 
question  is  clearly  immense,  and  it  is  greatly  to 
be  desired  that  its  study  should  be  encouraged. 

M.  Foster. 

April  26th,  1902. 


[sO 


REPORT  OF  A  PLAN  FOR  THE  INSTITUTION 
OF  AN  INTERNATIONAL  INQUIRY  INTO 
THE  SUBJECT  OF  HUMAN  NUTRITION 

[Sir  Michael  Foster's  "  Note  "  (preceding)  and  Professor 
Chittenden's  article  in  the  Popular  Science  Monthly  (follow- 
ing), which  form  a  part  of  this  book,  show  a  common  want  of 
exact  knowledge  relative  to  human  nutrition  not  at  all  credit- 
able to  human  intelligence  at  the  beginning  of  the  twentieth 
century ;  but  they  both  offer  hope  of  relief  from  this  discredit- 
able stigma  in  systematic  study  of  the  question.  For  this 
purpose  an  international  inquiry  was  proposed,  a  plan  was 
drawn  up  under  advice  of  Sir  Michael  Foster,  and  the  matter 
was  given  to  the  writer  to  promote  by  the  best  means 
available. 

The  Carnegie  Institution  seemed,  at  the  time,  the  most 
likely  supporter  of  such  a  scheme  ;  but  owing  to  an  embarrass- 
ment of  applications  for  support  of  American  science  needs,  it 
was  considered  best  not  to  attempt  any  foreign  or  even  inter- 
national benefaction,  for  the  present  at  least,  and  hence  other 
means  of  furthering  the  inquiry  were  sought. 

The  invitation  of  Professor  Chittenden  to  repeat  the  dem- 
onstration of  food-economy  made  by  the  author  and  Dr.  Van 
Someren  at  Cambridge,  England,  of  which  Sir  Michael  Foster's 
"  Note  "  treats,  at  the  laboratories  of  the  Sheffield  Scientific 
School  of  Yale  University,  led  to  the  discovery  that  New 
Haven  already  possessed  an  equipment  suitable  for  the  in- 
quiry much  more  complete  than  the  plan  Professor  Foster  had 
outlined  as  being  desirable. 

At  Yale  were  found  not  only  a  very  well-adapted  chemico- 
physiological  laboratory  with  some  of  the  most  active  and 
scientifically  respected  research  talent  of  the  world  in  charge, 
but  the  laboratory  stood  only  three  minutes  away  from  one  of 
the  best  furnished  gymnasiums  in  the  world,  under  a  director 
who  is  an  M.  D.  of  twenty  years'  experience,  as  well  as  a 
famous  athlete  and  author  of  an  athletic  manual.     It  so  hap- 

[S3] 


The  A.B.-Z.  of  Our  Own  Nutrition 

pened  that  this  gymnasium  was  especially  suited  for  assisting 
in  a  research  into  the  very  causes  of  human  efficiency,  or  lack 
of  it,  which  nutrition  is  supposed  to  affect. 

Only  forty  minutes  from  New  Haven  by  rail,  —  a  distance 
not  greater,  as  measured  by  time  separation,  than  from  one 
side  of  London  to  the  other,  —  at  Middletown,  Conn.,  stood 
also  the  recently  completed  calorimeter  of  Professors  Atwater 
and  Benedict  ready  for  making  a  calorimetric  trial-balance 
measurement  of  metabolism  attained  and  chemically  estimated 
in  the  tests  at  New  Haven. 

After  the  Yale  demonstration,  of  which  Professor  Chitten. 
den's  article,  previously  mentioned,  treats,  the  author  responded 
to  an  invitation  from  Professor  Atwater  and  submitted  himself 
to  a  32-hour  confinement  in  the  calorimeter  for  confirmation 
of  the  results  obtained  at  New  Haven. 

This  experience  in  the  calorimeter  at  Middletown  was  very 
significant  and  instructive.  The  author  was  the  first  test-sub- 
ject used  in  the  newly  completed  calorimeter.  The  oxygen- 
measuring  attachment  of  Dr.  Benedict  that  completed  the 
apparatus  and  gave  a  complete  trial  balance  of  the  metabolism 
of  the  subject  under  examination  was  as  yet  untried,  but  it 
proved  its  integrity  within  the  fraction  of  one  per  cent  and 
registered  as  accurately  as  necessary  for  all  practical  purposes. 
So  much  for  the  machine ;  but  it  measured  a  result  which  is 
of  the  greatest  importance  to  the  human  race.  The  author 
had  just  demonstrated  the  possibility  of  running  the  human 
machine  on  half  the  heat,  on  one-third  of  the  fuel,  and  with 
only  one-tenth  of  the  waste,  as  represented  by  the  waste,  or 
ashes  of  digestion.  Not  only  was  this  done  while  in  pursuit 
of  the  ordinary  activity  of  present-day  life,  but  under  stress  of 
'Varsity-Crew  exercise,  as  reported  by  Professor  Chittenden 
and  Dr.  Anderson.  Had  this  demonstration  been  made  rela- 
tive to  steam  engines  or  electrical  motors,  the  information 
would  have  been  revolutionary  in  establishing  new  values  for 
things  industrial  and  commercial. 

Its  significance  relative  to  human  profitable  possibilities 
is  even  more  important  than  if  related  to  steam  or  electrical 
power.  The  possibility  of  economy  in  the  human  machine 
gives  also  a  hope  of  immunity  from  the  common  diseases 
which  now  afflict  mankind. 

The  trial  of  the  calorimeter  as  a  measuring  machine  and 

[54] 


The  A.  B.-Z,of  Our  Own  Nutrition 

the  trial  balance  of  the  economic  metabolism  which  the  author 
had  attained  by  five  years  of  careful  attention  to  the  natural 
requirements  of  nutrition  were  epoch-making  events  coinci- 
dently  related,  and  for  them  the  author  here  makes  this  dis- 
tinguished claim  —  not  on  account  of  any  accomplishment  of 
himself,  but  as  a  promise  of  gp-eat  possibilities  for  human 
betterment. 

Here  follows  a  reproduction  of  the  plan  just  referred  to, 
with  facsimile  of  the  signatures  of  the  distinguished  physiolo- 
gists who  approved  the  plan  and  consented  to  serve  as  **  As- 
sessors." To  this  list  should  have  been  added  the  name  of 
Professor  Ozawa,  professor  of  physiology  at  the  University  of 
Tokio,  Japan ;  but  time  and  distance  did  not  permit  gaining 
the  required  understanding  and  assent.  Professor  Ozawa's 
connection  with  the  inquiry  would  make  it  not  only  inter- 
national but  interhemispherical  and  interracial  as  well,  and 
this  possibility  of  scientific  coordination  and  cooperation  is 
typical  of  the  harmonising  wave  that  is  fast  enveloping  the 
earth  for  the  benefit  of  mankind. 

I  give  a  copy  of  the  document  entire,  with  estimates  of 
cost,  etc.,  just  as  it  was  originally  drawn  and  intended  only  as 
a  trial  suggestion,  to  be  modified  by  circumstances.  —  Horace 
Fletcher.] 


PROPOSAL  TO  FOUND  AN  INTER- 
NATIONAL LABORATORY  OF 
RESEARCH  FOR  THE  STUDY  OF 
NUTRITION   IN   ALL   ITS  ASPECTS 

Notwithstanding  the  enormous  development 
which  the  study  of  Experimental  Physiology  has 
undergone  during  the  last  half-century,  and  the 
constant  multiplication  of  physiological  labora- 
tories fitted  in  a  manner  which  enables  them  to 
be  used  as  places  of  research  as  well  as  of 
instruction  in  the  methods  of  physiological  in- 
[55] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

quiry,  it  has  appeared  to  many  physiologists 
that  a  great  need  remains  to  be  supphed  by  the 
establishment  of  an  International  Laboratory  of 
Research,  devoted  primarily,  if  not  exclusively, 
to  the  investigation  of  problems  connected  with 
the  Nutrition  of  the  Animal,  and  particularly  of 
Human  Organisms,  —  studies  particularly,  and 
in  the  first  instance,  from  the  point  of  view  of  the 
relation  of  the  food  consumed  by  the  animal 
body  to  its  output  of  energy,  either  in  the  form 
of  heat  or  mechanical  work. 

The  reason  for  establishing  such  a  labora- 
tory, available  for  the  use  of  investigations  of  all 
nations,  is  to  be  found  in  the  fact  that  the  re- 
searches which  are  now  called  for,  in  order  to 
place  upon  a  firm  foundation  our  knowledge  of 
food  and  its  relations  to  the  activity  of  the  organ- 
ism, necessitates  an  assemblage  of  apparatus  and 
machinery  so  specialised  and  so  costly  that  they 
are  not  to  be  found  collected  together  even  in  the 
best  equipped  of  the  physiological  laboratories 
of  Europe  or  America,  which  all  subserve  in  the 
first  instance  the  purposes  of  systematic  instruc- 
tion. Undoubtedly,  unquestionably,  certain  of 
the  great  and  costly  appliances  of  research  are 
to  be  found  in  particular  laboratories,  as,  for  in- 
stance, in  those  of  Berlin,  Munich,  Paris,  and 
Turin,  but  there  certainly  exists  no  laboratory 
in  which  the  investigator  can  find  assembled 
[S6] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

under  one  roof  all  the  specially  fitted  chemical, 
physical,  and  even  bacteriological  appliances 
which  he  may  need  to  employ  in  the  investiga- 
tion of  the  Phenomena  of  Nutrition. 

A  more  precise  conception  of  the  nature  of 
the  proposed  laboratory  may  be  formed  if  refer- 
ence is  made  to  certain  groups  of  appHances 
which  such  a  laboratory  should  possess  and  be 
able  to  place  at  the  disposal  of  the  scientific 
men  coming  to  it  for  facilities  which  may  be 
denied  them  at  home.  It  should  possess  a 
complete  set  of  respiration  chambers  of  various 
types,  and  especially  should  be  provided  with 
the  "  Atwater  Respiration  Apparatus ; "  the 
most  perfect  appliances  for  the  analyses  of  gases 
should  be  available ;  it  should  be  provided  with 
the  most  perfect  calorimeters  of  various  types, 
both  for  the  investigation  of  the  calorimetric 
value  of  the  foods  experimented  on,  and  for  the 
determination  of  the  heat  produced  by  man  or 
by  the  lower  animals,  —  the  subjects  of  observa- 
tion. The  laboratory  should  possess,  besides, 
the  most  perfect  appliances  for  th'^  measure- 
ment of  work  done  by  man  and  by  animals 
("  ergostat,"  "  ergograph  "),  and  a  set  of  bal- 
ances of  the  highest  perfection  capable  of  weigh- 
ing with  accuracy  very  heavy  loads.  These 
characteristic  appliances  of  a  laboratory  spe- 
cially designed  for  placing  our  knowledge  of 
[57] 


The  A,B.-Z,  of  Our  Own  Nutrition 

Animal  Nutrition  on  a  thoroughly  sound  basis 
must  be  superadded  to  the  ordinary  means  for 
pursuing  with  success  researches  in  Pure  Or- 
ganic, Physiological,  and  Physical  Chemistry,  as 
well  as  in  Bacteriology. 

Outline    of   the   Proposed   Subjects  of 

Research  to  be  Undertaken  in  the 

Proposed  International 

Laboratory 

I.  To  determine  with  greater  precision  than 
has  yet  been  possible  the  efficiency  of  the  ani- 
mal organism  considered  as  a  machine  in  which 
potential  energy  of  the  organic  constituents  of 
food  is  converted  into  mechanical  work.  The 
knowledge  that  we  already  possess  has  shown 
that  in  the  animal  we  have  an  engine  infinitely 
more  efficient  as  a  utiliser  of  the  potential  en- 
ergy supplied  to  it  than  any  appliance  yet  con- 
structed, or  which  we  can,  in  the  present  state 
of  physical  science,  construct.  A  still  more  pre- 
cise study  of  the  actual  efficiency  of  the  animal 
as  a  whole,  as  well  as  of  certain  of  the  vital  or- 
gans which  are  mainly  concerned  in  mechanical 
work,  and  a  more  thorough  investigation  of  the 
processes  whereby —  for  instance,  in  the  muscles 
—  the  potential  energy  of  stored-up  chemical 
compounds  is,  as  appears  certain,  directly  con- 
verted into  mechanical  work,  is  not  only  desira- 

[58] 


The  A.B,-  Z,  of  Our  Own  Nutrition 

ble  in  the  interest  of  the  ultimate  object  of  the 
work  of  the  Laboratory,  but  possesses  a  high 
degree  of  theoretical  interest,  even  from  the 
point  of  view  of  Pure  Physics.  To  sum  up : 
One  of  the  first  objects  of  the  investigations  to 
be  carried  out  in  the  projected  Laboratory 
should  be  "  the  more  precise  determination  of 
the  minimum  transformation  of  energy  which 
corresponds  to  mean  and  accurately  determined 
conditions  of  the  animal  body,  and  of  that  of 
man  in   particular." 

2.  We  are  acquainted  with  the  fact  that  the 
potential  energy  which  is  utilised  by  the  animal 
is  supplied  to  it  with  the  least  wear  and  tear  to, 
or  strain  upon,  its  mechanism  by  non-nitrog- 
enous organic  constituents  of  food  which  must 
belong  to  the  groups  of  starches  and  sugars  or 
fats,  but  that  the  continued  existence  of  the 
organism  demands,  as  an  essential  condition, 
the  introduction  of  a  certain  proportion  of  albu- 
minous matter.  In  spite  of  numerous  very  fine 
investigations  on  this  subject,  the  yet  more 
precise  determination  of  the  minimum  quantity 
of  the  albuminous  constituents  which  are  abso- 
lutely necessary  or  desirable,  under  the  most 
varying  conditions,  is  eminently  desirable,  espe- 
cially in  the  light  of  recently  recorded  facts, 
amongst  which  are  those  to  be  referred  to 
under  3  (following)  :  — 

[59] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

3.  Certain  very  noteworthy  observations 
made  by  Messrs.  Horace  Fletcher  and  Ernest 
H.  Van  Someren  have  shown  that  an  excessively 
prolonged  mastication  and  insalivation  of  food 
leads  to  remarkable  results  in  respect  to  the 
diminution  of  the  total  quantity  of  food  neces- 
sary to  keep  the  body  in  a  state  of  health,  and 
to,  as  is  alleged,  a  remarkable  improvement  in 
the  digestive  functions  as  well  as  of  the  general 
health  of  the  individual.  It  appears  highly  im- 
portant thoroughly  to  investigate  the  remarkable 
phenomena  discovered  by  Messrs.  Fletcher  and 
Van  Someren,  and  to  determine  how  far  they 
may  lead  to  a  modification  of  or  improvement 
in  the  dietary  of  healthy  individuals  and  of  per- 
sons in  a  state  of  disease. 

4.  Indeed,  it  may  truly  be  said  that  the  aver- 
age diet  of  man,  that  is  to  say,  the  absolute  and 
relative  amount  of  certain  food-stuffs  on  which 
an  average  man  should  live,  is  at  present,  to  a 
large  extent,  determined  in  an  empirical  manner. 
It  is  most  necessary  that  this  should  be  deter- 
mined in  an  exact  manner,  since  it  is  at  least 
possible  that  a  more  complete  knowledge  may 
reveal  that  the  good  results  thus  obtained  em- 
pirically are  only  reached  by  means  of  an  excess 
of  one  element  being  counterbalanced  by  excess 
of  another  element,  and  thus  open  up  a  way  to 
considerable   economy.     The   changes   needed 

[60] 


l^he  A.B.-Z.  of  Our  Own  Nutrition 

for  variations  from  the  average,  to  meet  certain 
conditions,  are  also  at  present,  to  a  very  large 
extent,  determined  empirically,  and  these  also 
most  certainly  ought  to  be  determined  in  an  ab- 
solutely exact  manner. 

5.  The  researches  of  Pawlow  on  the  condi- 
tions vvhich  influence  the  activity  of  the  secret- 
ing glands  of  the  organs  of  digestion,  upon  the 
relation  of  their  activity  to  the  nature  of  the  food 
ingested,  upon  the  influence  exerted  by  the  se- 
cretion of  the  glands  situated  in  one  part  of  the 
alimentary  canal,  upon  the  activity  of  glands 
situated  lower  down,  indicate  lines  of  research 
only  recently  opened  out,  but  the  importance 
of  which  in  reference  to  the  problems  of  nutri- 
tion is  probably  great. 

6.  Similarly,  the  facts  which  have  in  recent 
times  been  ascertained  in  reference  to  the  re- 
markable influence  exerted  by  the  so-called 
"  internal  secretion  "  of  certain  ductless  glands 
on  the  general  metabolism,  the  part  played  by 
the  pancreas  in  reference  to  the  transformations 
of  sugar  in  the  body  indicate  yet  other  lines  of 
research  to  be  carried  out  in  connection  with 
the  main  inquiry. 

In  conclusion :  The  final  problem  of  the 
work  of  the  proposed  Laboratory  will  be  to  as- 
certain the  conditions  which  will  "  render  it  pos- 
sible to  obtain  from  the  human  machine,  under 

[61] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

varying  conditions,  the  highest  efficiency  at  the 
least  cost." 

The  value  of  results  which  may  be  thus 
obtained,  considered  from  the  point  of  view  of 
social,  political,  and  administrative  economy,  is 
hardly  to  be  exaggerated. 

Suggestions  as  to  Staff  and  Personnel 

OF  THE  Proposed  International 

Laboratory 

For  the  coordination  and  general  direction 
of  the  several  investigations,  the  services  of  an 
eminent  physiological  chemist  (preferably  one 
having  the  principal  European  languages  at  his 
command)  is  essential. 

Such  a  director  would  need  at  least  two  effi- 
cient permanent  technical  assistants,  as  for  in- 
stance, one  to  deal  with  the  problems  of  Organic 
Chemistry,  and  another  competent  to  deal  with 
the  problems  of  Physical  Chemistry.  Other 
assistants  might  be  necessary,  but  it  would 
probably  be  desirable  that  the  Institute  should 
have  the  power  of  subsidising,  for  a  longer  or 
shorter  period,  men  who  would  undertake  special 
investigations  in  coordination  with  the  general 
work,  and  who  would  thus  be,  as  it  were,  tem- 
porary assistants.  This  would  be  quite  apart 
from  the  general  hospitality  of  the  Laboratory 
offered  by  the  Institute  to  other  investigators. 


The  A.B.-  Z,  of  Our  Own  Nutrition 
Estimates  for  the  Proposed  Laboratory 

INITIAL   OUTLAY 

Director $SyOOO  $5,000 

Permanent  and  Temporary  Assistants      7,500  to   10,000 

Other  General  Maintenance  ....      5,000  to     7,500 

$17,500  $22,500 

With  regard  to  the  second  item,  the  per- 
manent assistants  would  be  required  at  the  out- 
set, but  the  temporary  assistants  would  be  taken 
on  as  opportunity  offered.  Less  than  even  the 
lower  estimate  might  suffice  at  first. 

Regarding  the  third  item,  also,  the  maximum 
might  not  be  required  in  the  beginning. 

Suggestions  as  to  Desirability  of  Loca- 
tion 

The  place  fitted  for  the  establishment  of  an 
International  Institute  should  be  one  which  can 
be  reached  with  comparative  facility  by  investi- 
gators of  the  different  nationahties.  It  must  be 
one  free  from  the  objections  due  to  national  sus- 
ceptibilities. It  should  also  be,  if  possible,  a 
place  agreeable  to  live  in ;  a  place  where  work 
can  be  carried  on  through  the  year ;  and  a  place 
where  expenses,  both  the  personal  expenses  of 
the  investigators,  and  the  general  expenses  of  the 
Institute,  are  not  excessive.  Venice  has  been 
suggested  as  a  place  fulfilling  the  above  require- 

[63] 


"The  A,  B.-Z,of  Our  Own  Nutrition 

ments.  It  can  be  reached  readily  from  all  parts 
of  Europe,  and  is  as  accessible  to  Americans  as 
any  other  European  city.  Living  is  very  cheap, 
and,  indeed,  all  expenses  are  very  moderate. 

On  sea  level  itself,  Venice  is  within  near  dis- 
tance of  very  high  altitude,  and  hence  offers 
facilities  for  the  study  of  the  effects  of  cHmatic 
influence  on  nutrition.  It  is  also  sufficiently 
near  the  Regina  Margherita  Laboratory,  on 
Monte  Rosa,  to  enable  the  observations  made 
at  the  two  places  to  be  coordinated.  Venice  is, 
moreover,  a  cosmopolitan  centre;  and  persons 
of  many  different  nations  and  races  might  read- 
ily be  obtained  as  subjects  for  observation  and 
experiment. 

On  the  other  hand,  it  may  be  regarded  as 
essential  to  the  complete  success  of  the  pro- 
posed Institute  that  both  the  director  and  those 
engaged  in  investigation  should  have  ample  op- 
portunities of  ready  and  frequent  intercourse 
with  eminent  men  engaged  in  investigation  in 
Physics,  Chemistry,  and  the  allied  sciences.  The 
help  which  is  thus  gained  by  intercourse  with 
men  at  the  very  head  of  various  scientific  inquiry 
cannot  be  supplied  in  any  other  way.  There  is 
also  an  urgent  reason  for  ready  access  to  a  most 
thoroughly  equipped  scientific  library.  It  is 
also  essential  that  the  Institute  should  have 
facility  of  obtaining,  or  of  getting  constructed, 

[64] 


The  A,B.-Z,ofOur  Own  Nutrition 

with  the  least  possible  delay  such  apparatus  as 
it  might  need.  These  essentials  cannot  be  sup- 
plied otherwhere  than  in  great  centres  of  scien- 
tific activity.  A  small  university  cannot  supply 
them.  If  they  are  insisted  on,  the  Institute 
must  be  located  in  a  place  which  has  metro- 
politan distinction  and  holds  not  only  a  large 
but  an  active  university.  The  choice  of  a  situa- 
tion, from  this  point  of  view,  in  Europe,  is  thus 
almost  limited  to  such  places  as  Paris,  Berlin, 
Vienna,  or  London.  Of  these  London  prob- 
ably best  recommends  itself  for.  international 
purposes. 

But,  on  the  other  hand,  London  is  distinctly 
an  expensive  place  to  live  in.  Indeed,  all  ex- 
penses there  are  great,  and  the  same  may  be 
said  of  any  great  metropolitan  centre.  More- 
over, London  cannot  be  reached  from  the  coun- 
tries of  Europe  without  sea  transit. 

The  choice  between  such  a  place  as  London 
and  such  a  place  as  Venice  must  depend  upon 
the  relative  weight  attached,  on  the  one  hand,  to 
the  scientific  advantages  dwelt  on  above,  and, 
on  the  other  hand,  to  the  advantages  other  than 
scientific. 


[6s] 


"The  A.B.-  Z.  of  Our  Own  Nutrition 

Suggestions  as   to   Management  of  the 
Proposed  International  Institute 

It  is  proposed  that :  First,  there  should  be  a 
small  body  of  trustees  who  should  undertake  the 
financial  responsibility;  and,  Second,  a  board 
of  scientific  assessors,  representing  several  na- 
tions, who,  in  conjunction  with  the  director, 
should  exercise  general  supervision  of  the  work 
of  the  Institute.  Such  a  board  need  meet  only 
at  rare  intervals,  much  being  done  by  way  of 
correspondence.  The  expenses  which  the  mem- 
bers incur  in  the  exercise  of  their  functions  ought 
to  be  met  out  of  the  funds  of  the  Institute. 


[66] 


The  A,B,-Z.  of  Our  Own  Nutrition 

The  following  have  expressed  willingness  to 
act  as  scientific  assessors:  — 


^7^       • 


[67] 


NATIONALITY  AND  SCIENTIFIC  TITLES  OF  OUR 
BOARD   OF  SCIENTIFIC   ASSESSORS 

Sir  Michael  Foster,  M.  D.,  K.  C.  B.,  F.  R.  S.,  M.  P.,  etc. 
Late  Professor  of  Physiology,  University  of  Cambridge, 
England ;  Secretary  of  the  Royal  Society ;  Permanent 
Honorary  President  of  the  International  Congress  of 
Physiologists,  etc. 

Dr.  Professor  Angelo  Mosso.  Professor  of  Physiology, 
University  of  Turin,  Italy ;  Director  of  the  Regina  Mar- 
gherita  Biological  Station  on  the  summit  of  Monte  Rosa, 
etc 

Dr.  Professor  Hugo  Kronecker.  Professor  of  Physiol- 
ogy, University  of  Berne,  Berne,  Switzerland,  etc. 

Dr.  Professor  N.  Zuntz.  Professor  of  Physiology,  Berlin, 
Germany,  etc. 

Dr.  Professor  Paul  Heger.  Professor  of  Physiology, 
Brussels,  Belgium ;  Director  of  the  Solvay  Sociological 
Institute,  Brussels. 

Dr.  Professor  A.  Dastre.  Professor  of  Physiology,  Uni- 
versitie  de  la  Sorbonne,  Paris,  France,  etc. 

Dr.  Professor  Henry  Pickering  Bowditch,  Professor 
of  Physiology,  Harvard  Medical  School ;  Second  Presi- 
dent American  Physiological  Society ;  President  of  the 
Children's  Aid  Society,  Boston,  Mass.,  etc. 

Professor  Russell  H.  Chittenden.  Director  Sheffield 
Scientific  School  of  Yale  University ;  Professor  of  Physi- 
ological Chemistry  in  Yale  ;  Present  President  of  the 
American  Physiological  Society,  etc. 

Dr.  Professor  William  H.  Welch.  Professor  of  Pathol- 
ogy in  Johns  Hopkins  University,  Baltimore,  Maryland ; 
President  of  the  Rockefeller  Institute  of  Preventive  Medi- 
cine, etc. 

Dr.  Professor  J.  P.  Pawlow.  Director  of  the  Depart- 
ment of  Experimental  Physiology  in  the  Russian  Imperial 
Military  School  of  Medicine,  etc. 


[68] 


PERSISTENT   SCIENTIFIC   DOUBTS 

[Notwithstanding  the  report  of  the  Cambridge  examina- 
tion of  the  claims  for  an  economic  nutrition  advanced  by  the 
authors,  American  physiologists  were  still  doubtful  if  a  nitrog- 
enous economy  like  that  reported  could  be  maintained,  and 
the  writer  was  invited  to  submit  to  further  tests  at  the  Physi- 
ological Laboratory  of  Yale  University,  under  direction  of 
Professor  Russell  H.  Chittenden,  Director  of  the  Sheffield 
Scientific  School,  and  President  of  the  American  Physiologi- 
cal Society,  and  Dr.  Lafayette  B.  Mendel. 

The  following  article,  first  published  in  the  Popular 
Scierue  Monthly,  June,  1903,  is  a  report  of  that  test,  and  in- 
dicates a  desire  to  carry  the  investigation  further  to  include 
a  variety  of  test-subjects. 

In  response  to  Professor  Chittenden's  request,  the  Trus- 
tees of  the  Bache  Fund  of  the  National  Academy  of  Sciences 
appropriated  $1000  towards  a  more  extended  inquiry;  and 
other  means  having  been  assured,  a  project  of  experiments 
was  taken  under  consideration. 

One  of  the  difficulties  encountered  was  the  control  of 
test-subjects  for  a  sufficiently  long  time  to  make  conclusive 
estimates  relative  to  the  minimum  needs  of  nitrogenous  food 
in  relation  to  the  common  occupations  of  life.  Few  if  any 
volunteers,  with  the  leisure  and  interest  fortunately  possessed 
by  the  writer,  were  available  outside  the  laboratory  force 
itself,  and  there  were  serious  objections  to  using  for  test-sub- 
jects the  same  persons  who  did  the  chemical  analyses  and 
estimated  the  results. 

In  this  dilemma  the  good  fortune  of  a  meeting  with  Sur- 
geon-General O'Reilly  of  the  United  States  Army  and  with 
General  Leonard  Wood  —  the  former  on  his  way  to  Madrid  to 
attend  a  medical  congress,  and  the  latter  en  route  to  the 
Philippines  to  take  command  there  —  happened  to  the  writer 
on  the  S.  S.  Commonwealth,  on  a  voyage  to  Italy  in  April, 
1903. 

[69] 


The  A,B.'Z,  of  Our  Own  Nutrition 

Both  these  officers  are  medical  men  and  research  enthusi- 
asts. They  had  fought  yellow  fever  together,  in  cooperation 
with  martyr  Dr.  Major  Walter  Reed,  in  Cuba,  and  the  fame 
of  their  success  was  being  talked  of  as  one  of  the  great 
triumphs  of  pathologic,  or  hygienic,  science  at  the  time  of 
the  meeting. 

There  was  ample  time  on  the  steamer  to  discuss  a  sub- 
ject of  such  mutual  and  general  interest,  and  both  officers  had 
had,  in  service,  experiences  that  led  them  to  believe  that  the 
results  obtained  by  the  writer  and  his  colleagues  were  the 
common  possibilities  of  all  persons  under  right  conditions  of 
alimentation. 

General  O'Reilly  was  of  the  opinion  that  the  corps  he  com- 
manded could  furnish  intelligent  and  earnest  test-subjects  for 
nutrition  investigation,  as  it  did  in  the  yellow  fever  case.  In 
the  yellow  fever  investigation  privates  and  officers  alike  had 
volunteered  to  act  as  test-subjects,  even  though  their  lives 
were  at  stake  and  many  had  already  been  sacrificed.  It  is 
to  their  great  honour,  also,  that  they  refused  to  receive  the 
bounty  that  was  offered  for  test-subjects,  preferring  to  serve 
science  and  humanity  freely  as  volunteers  rather  than  sell 
themselves  as  experimental  risks.  From  such  material  Gen- 
eral O'Reilly  was  sure  that  capable  assistants  could  be  secured 
to  test  the  not  at  all  dangerous  or  disagreeable  economies  of 
nutrition  that  the  projected  inquiry  wished  to  solve. 

Armed  with  letters  of  recommendation  to  the  President 
and  to  the  Secretary  of  War  from  General  Wood,  and  an 
invitation  from  Surgeon-General  O'Reilly  to  call  on  him  if 
cooperation  on  his  part  were  desired,  the  writer  returned  to 
the  United  States  and  consulted  with  Professors  Chittenden 
and  Bowditch  relative  to  the  desirability  of  army  cooperation. 
It  was  believed  to  be  just  the  thing  wanted  to  facilitate  the 
inquiry,  and  the  writer  proceeded  to  Washington  to  effect  the 
combination. 

General  O'Reilly  had  already  had  the  matter  under  con- 
sideration and  was  quite  ready  to  draw  up  a  project  for  pres- 
entation to  the  Secretary  of  War  when  Mr.  Root  should 
return  to  Washington  from  his  summer  vacation. 

Twenty  privates  and  three  non-commissioned  officers  of 
the  Hospital  Corps  of  the  United  States  Army  under  com- 
mand of  Dr.  Lieutenant  Wallace  DeWitt  are  now  quartered  at 

[70] 


The  A.B.'  Z.  of  Our  Own  Nutrition 

New  Haven  in  cooperation  with  the  staff  of  the  Sheffield 
Scientific  School.  It  is  the  intention  to  learn,  if  possible,  how 
little  nitrogen  is  necessary  to  secure  the  best  human  efficiency ; 
and  also,  if  possible,  to  ascertain  some  measure  of  the  evil 
effects  of  an  excess  of  nitrogenous  food  as  well  as  excess  of 
food  in  general  upon  human  efficiency. 

The  writer  is  grateful  for  the  good  fortune  of  being  able  to 
be  of  service  in  a  development  of  interest  in  a  subject  which 
is  of  vital  importance  to  the  human  race.  He  has  enjoyed 
the  benefits  of  an  economic  nutrition  and  knows  its  value. 

The  practical  proof  of  a  subject  of  personal  application  must 
come  from  such  personal  application.  Each  person  must  be 
his  own  doctor  and  his  own  scientist  in  the  matter  of  his  ali- 
mentation or  he  runs  the  risk  of  running  amuck  in  his  health 
economy.  There  is  not  so  much  to  learn,  neither  is  there  very 
much  to  do  to  insure  right  alimentation,  perfect  digestion, 
and  continuous  good  health;  but  the  little  required  of  us 
must  be  attended  to  with  no  lapses  of  attention.  —  Horace 
Fletcher.] 


[71] 


PHYSIOLOGICAL  ECONOMY   IN 
NUTRITION 

By  Russell  H.  Chittenden 
Director  of  the  Sheffield  Scientific  School  of  Yale  University 

Among  the  many  problems  awaiting  solu- 
tion, none  is  of  greater  importance  for  the 
welfare  of  the  individual  and  of  the  race  than 
that  which  relates  to  the  proper  nutrition  of  the 
body.  Man  eats  to  live  and  to  gain  strength 
for  his  daily  work,  and  without  sufficient  nutri- 
ment the  machinery  of  the  body  cannot  be  run 
smoothly  or  with  proper  efficiency.  The  taking 
of  an  excess  of  food,  on  the  other  hand,  is  just 
as  harmful  as  insufficient  nourishment,  involving, 
as  it  does,  not  only  wasteful  expenditure  but, 
what  is  even  of  greater  moment,  an  expenditure 
of  energy  on  the  part  of  the  body,  which  may  in 
the  long  run  prove  disastrous.  While  it  is  the 
function  of  food  to  supply  the  material  from 
which  the  body  can  derive  the  necessary  energy 
for  its  varied  activities,  any  excess  of  food  over 
and  above  what  is  needed  to  make  good  the 
loss  incidental  to  life  and  daily  activity  is  just  so 


The  A,B,-  Z.  of  Our  Own  Nutrition 

much  of  an  incubus,  which  is  bound  to  detract 
from  the  smooth  running  of  the  machinery  and 
to  diminish  the  fitness  of  the  body  for  perform- 
ing its  normal  functions. 

A  proper  physiological  condition  begets  a 
moral,  mental,  and  physical  fitness  which  cannot 
be  attained  in  any  other  way.  Further,  it  must 
be  remembered  that  lack  of  a  proper  physi- 
ological condition  of  the  body  is  more  broadly 
responsible  for  moral,  social,  mental,  and  phys- 
ical ills  than  any  other  factor  that  can  be  named. 
Poverty  and  vice  on  ultimate  analysis  may  often 
be  traced  to  a  perversion  of  nutrition.  A 
healthy  state  of  the  body  is  a  necessary  con- 
comitant of  mental  and  moral  vigour,  as  well  as 
of  physical  strength.  Abnormal  methods  of 
living  are  often  the  accompaniment  or  fore- 
runner of  vicious  tastes  that  might  never  have 
been  developed  under  more  strictly  physiologi- 
cal conditions.  Health,  strength  (mental  and 
physical),  and  moral  tone  alike  depend  upon 
the  proper  fulfilment  of  the  laws  of  nature,  and 
it  is  the  manifest  duty  of  a  people  hoping  for 
the  fullest  development  of  physical,  mental,  and 
moral  strength  to  ascertain  the  character  of 
these  laws  with  a  view  to  their  proper  observ- 
ance. Poverty,  crime,  physical  ills,  and  a  blunted 
or  perverted  moral  sense  are  the  penalties  we 
may  be  called  upon  to  pay  for  the  disobedience 

[73] 


The  A,B,--  Z.  of  Our  Own  Nutrition 

to  Nature's  laws;  penalties  which  not  only  we 
may  have  to  pay,  but  which  may  be  passed 
down  to  succeeding  generations,  thereby  influ- 
encing the  lives  of  those  yet  unborn. 

There  is  to-day  great  need  for  a  thorough 
physiological  study  of  those  laws  of  nutrition 
which  constitute  the  foundation  of  good  living. 
It  is  a  subject  full  of  interest  and  promise  for 
the  sociologist  and  economist,  as  well  as  for  the 
physiologist.  We  need  a  far  more  complete 
knowledge  than  we  possess  at  present  of  the 
laws  governing  nutrition ;  we  need  fuller  knowl- 
edge of  the  methods  by  which  the  most  com- 
plete satisfactory,  and  economical  utilisation  of 
the  oiet  can  be  obtained ;  we  need  to  know 
more  concerning  the  minimum  diet  and  the 
minimum  amount  of  proteid  or  albuminous  foods 
on  which  health,  mental  and  physical  vigour  can 
be  permanently  maintained ;  we  need  to  know 
more  fully  concerning  the  influence  of  various 
forms  of  food  on  growth  and  recuperative 
power ;  we  need  more  complete  knowledge  re- 
garding the  r6le  of  various  dietetic  and  digestive 
habits,  fixed  or  acquired ;  the  efl"ects  of  thor- 
ough mastication,  insalivation,  and  the  influ- 
ence of  two  versus  three  meals  a  day  upon  the 
utiHsation  of  food  and  hence  upon  the  bodily 
health.  Further,  we  need  more  concise  infor- 
mation as  to  the  eff'ect  of  the  mental  state  upon 
[74] 


'The  A,B,-Z.  of  Our  Own  Nutrition 

digestion  and  nutrition.  These  and  many  other 
problems  of  a  like  nature  confront  us  when  we 
attempt  to  trace  the  influence  of  a  proper  nutri- 
tion upon  the  condition  of  the  body.  These 
problems,  however,  all  admit  of  solution,  and 
in  their  solution  undoubtedly  lies  the  remedy 
for  many  of  the  personal  ills  of  mankind. 

The  foregoing  thoughts  have  been  suggested 
by  observations  recently  made  in  the  writer's 
laboratory  on  the  amount  and  character  of  the 
food  actually  required  by  a  healthy  man  in  the 
maintenance  of  bodily  equilibrium  in  periods 
of  rest  and  physical  work.  Our  ideas  at  pres- 
ent are  based  primarily  upon  observations  as  to 
what  civilised  peoples  are  accustomed  to  do, 
and  not  upon  what  they  need  to  do  in  order  to 
meet  the  demands  made  upon  the  body.  Sir 
William  Roberts  has  well  said  that  the  palate  is 
the  dietetic  conscience,  but  he  adds  that  there 
are  many  misfit  palates,  and  we  may  well  query 
whether  our  dietetic  consciences  have  not  be- 
come generally  perverted  through  a  false  mode 
of  living.  The  well-nigh  universal  habit  of 
catering  to  our  appetite  on  all  occasions,  of  bow- 
ing to  the  fancied  dictates  of  our  palates  even 
to  the  extent  of  satiety,  and  without  regard  to 
the  physiological  needs  of  the  body,  may  quite 
naturally  have  resulted  in  a  false  standard  of 
living,  in  which  we  have  departed  widely  from 

[75] 


T^he  A.B.-  Z.  of  Our  Own  Nutrition 

the  proper  laws  of  nutrition.  Statistical  studies 
carried  out  on  large  groups  of  individuals  by- 
various  physiologists  have  led  to  the  general 
acceptance  of  dietary  standards,  such  as  those 
proposed  by  Voit,  of  Munich,  and  Atwater  in 
this  country.  Thus  the  Voit  diet  for  a  man 
doing  moderate  work  is  ii8  grams  of  proteid  or 
albuminous  food,  56  grams  of  fat,  and  500  grams 
of  carbohydrates,  such  as  sugar  and  starch,  with 
a  total  fuel  value  of  3,055  large  calories  or  heat 
units  per  day.  With  hard  work,  Voit  increases 
the  daily  requirement  to  145  grams  of  proteid, 
160  grams  of  fat,  and  450  grams  of  carbohy- 
drates, with  a  total  fuel  value  of  3,370  large 
calories.  Atwater,  on  the  other  hand,  from  his 
large  number  of  observations,  is  inclined  to 
place  the  daily  proteid  requirement  at  125 
grams,  with  sufficient  fat  and  carbohydrate  to 
equal  a  total  fuel  value  of  3,500  large  calories 
for  a  man  doing  a  moderate  amount  of  work ; 
while  for  a  man  at  hard  work  the  daily  diet  is 
increased  to  150  grams  of  proteid,  and  with  fats 
and  carbohydrates  to  yield  a  total  fuel  value  of 
4,500  large  calories.  These  standards  are  very 
generally  accepted  as  being  the  requirement  for 
the  average  individual  under  the  given  condi- 
tions of  work,  and  it  may  be  that  these  figures 
actually  represent  the  daily  needs  of  the  body. 
Suppose,  on   the  other  hand,  that  we  have  in 

[76] 


The  j4.B.-  Z.  of  Our  Own  Nutrition 

these  figures  false  standards,  or,  in  other  words, 
that  the  quantities  of  foodstuffs  called  for  are 
altogether  larger  than  the  actual  demands  of 
the  body  require.  In  this  case  there  is  a  posi- 
tive waste  of  valuable  food  material  which  we 
may  calculate  in  dollars  and  cents ;  a  loss  of  in- 
come incurred  daily  which  might  be  expended 
more  profitably  in  other  directions.  To  the 
wage-earner  with  a  large  family,  who  must  of 
necessity  husband  his  resources,  there  is  in  our 
hypothesis  a  suggestion  of  material  gain  not  to 
be  disregarded.  The  money  thus  saved  might 
be  expended  for  the  education  of  the  children, 
for  the  purchase  of  household  treasures  tending 
to  elevate  the  moral  and  mental  state  of  the 
occupants,  or  in  many  other  ways  that  the  imag- 
ination can  easily  supply.  This  kind  of  saving, 
however,  is  purely  a  question  of  economy,  and 
in  some  strata  of  society  would  be  objected  to 
as  indicative  of  a  condition  of  sordidness.  It 
has  come  to  be  a  part  of  our  personal  pride  to 
have  a  well-supplied  table,  and  to  eat  largely 
and  freely  of  the  good  things  provided.  The 
poorer  man  takes  pride  in  furnishing  his  family 
with  a  diet  rich  in  expensive  articles  of  food,  and 
imagines  that  by  so  doing  he  is  inciting  them  to 
heartier  consumption  and  to  increased  health  and 
strength.  He  would  be  ashamed  to  save  in  this 
way,  under  the  honest  belief  that  by  so  doing  he 

[77] 


'The  A.B,-Z.  of  Our  Own  Nutrition 

might  endanger  the  health  of  his  dear  ones.  But 
let  us  suppose  that  this  hypothetical  waste  of  food 
is  not  merely  uneconomical,  that  it  is  undesirable 
for  other  and  weightier  reasons.  Indeed,  let  us 
suppose  that  this  unnecessary  consumption  of 
food  is  distinctly  harmful  to  the  body,  that  it  is 
physiologically  uneconomical,  and  that  in  our 
efforts  to  maintain  a  high  degree  of  efficiency 
we  are  in  reality  putting  upon  the  machinery  of 
the  body  a  heavy  and  entirely  uncalled-for  strain, 
which  is  bound  to  prove  more  or  less  detrimen- 
tal. If  there  is  truth  in  this  assumption,  our  hy- 
pothesis takes  on  a  deeper  significance,  and  we 
may  well  inquire  whether  there  are  any  reason- 
able grounds  for  doubting  the  accuracy  of  our 
present  dietary  standards. 

In  this  connection  it  is  to  be  remembered 
that  the  food  of  mankind  may  be  classified  under 
three  heads,  viz.,  proteid  or  albuminous^  such  as 
meat,  eggs,  casein  of  milk,  gluten  of  bread,  and 
various  vegetable  proteids;  carbohydrates,  as 
sugar  and  the  starches  of  our  cereals,  and  fats^ 
including  those  of  both  animal  and  vegetable 
origin.  The  proteids  are  characterised  by  con- 
taining nitrogen  (about  i6  per  cent),  while  the 
fats  and  carbohydrates  contain  only  carbon,  hy- 
drogen, and  oxygen.  The  two  latter  classes  of 
foodstuffs  are  burned  up  in  the  body,  when 
completely  utilised,  to  carbonic  acid  (a  gas)  and 

[78] 


The  A,B,'Z,  of  Our  Own  Nutrition 

water,  while  the  proteid  foods,  beside  yielding 
carbonic  acid  and  water,  give  off  practically  all 
of  their  nitrogen  in  the  form  of  crystalline  ni- 
trogenous products  in  the  excreta  of  the  body. 
Proteid  foods  have  a  particular  function  to 
perform,  viz.,  to  supply  the  waste  of  proteid 
matter  from  the  active  tissues  of  the  body,  and 
this  function  can  be  performed  only  by  the 
proteid  foods;  hence  the  latter  are  essential 
foodstuffs  without  which  the  body  cannot  long 
survive.  Fats  and  carbohydrates,  on  the  other 
hand,  are  mainly  of  value  for  the  energy  they 
yield  on  oxidation,  and  in  this  connection  it  is 
to  be  remembered  that  the  fuel  value  of  fats  per 
gram  is  much  larger  than  that  of  carbohydrates, 
viz.,  9.3  :  4.1,  or  more  than  twice  as  great.  Fur- 
ther, it  is  to  be  noted  that  the  various  foodstuffs 
cannot  be  utilised  directly  by  the  body,  but  they 
must  first  be  digested,  then  absorbed  and  as- 
similated, after  which  they  gradually,  in  their 
changed  form,  undergo  decomposition  with  lib- 
eration of  their  contained  energy,  which  may 
manifest  itself  in  the  form  of  heat  or  of  mechani- 
cal work.  The  thoroughness  with  which  foods  are 
digested  and  utilised  in  the  body  must  therefore 
count  for  a  great  deal  in  determining  their  die- 
tetic or  nutritive  value.  Moreover,  it  is  easy  to  see 
how  an  excess  of  proteid  food  will  give  rise  to 
a  large  proportion  of  nitrogenous  waste  matter, 

[79] 


The  A,  B,-Z,of  Our  Own  Nutrition 

which,  floating  through  the  system  prior  to 
excretion,  may,  by  acting  on  the  nervous  system 
and  other  parts  of  the  body,  produce  disagree- 
able results.  A  mere  excess  of  food,  even  of 
the  non-nitrogenous  variety,  must  entail  a  large 
amount  of  unnecessary  work,  thereby  using  up 
a  proportional  amount  of  energy  for  its  own  dis- 
posal, since  once  introduced  into  the  body  it  must 
be  digested  and  absorbed,  otherwise  it  under- 
goes fermentation  and  putrefaction  in  the  stom- 
ach and  intestines,  causing  countless  troubles. 
When  absorbed  in  quantities  beyond  the  real 
needs  of  the  body,  it  may  be  temporarily  de- 
posited as  fat ;  but  why  load  up  the  system  with 
unnecessary  material,  thereby  interfering  with 
the  free  running  of  the  machinery?  In  other 
words,  it  is  very  evident  that  the  taking  in  of 
food  in  quantities  beyond  the  physiological  re- 
quirements is  undesirable,  and  may  prove  ex- 
ceedingly injurious.  It  is  truly  uneconomical, 
and  defeats  the  very  ends  we  aim  to  attain. 
Instead  of  adding  to  the  bodily  vigour  and 
increasing  the  fitness  of  the  organism  to  do  its 
daily  work,  we  are  really  hampering  the  delicate 
mechanism,  upon  the  smooth  running  of  which 
so  much  depends. 

Why,  now,  should  we  assume  that  a  daily 
diet  of  over  lOO  grams  of  proteid,  with  fats  and 
carbohydrates  sufficient  to  make  up  a  fuel  value 
[So] 


"The  A.  B,-Z.of  Our  Own  Nutrition 

of  over  3, OCX)  large  calories,  is  a  necessary  req- 
uisite for  bodily  vigour  and  physical  and  mental 
fitness  ?  Mainly  because  of  the  supposition  that 
true  dietary  standards  may  be  learned  by  ob- 
serving the  relative  amounts  of  nutrients  actually 
consumed  by  a  large  number  of  individuals  so 
situated  that  the  choice  of  food  is  unrestricted. 
But  this  does  not  constitute  very  sound  evidence. 
It  certainly  is  not  above  criticism.  We  may 
well  ask  ourselves  whether  man  has  yet  learned 
wisdom  with  regard  to  himself,  and  whether  his 
instincts  or  appetites  are  to  be  entirely  trusted 
as  safe  guides  to  follow  in  the  matter  of  his 
own  nutrition.  The  experiments  of  Kumagawa, 
Siv^n,  and  other  physiologists,  have  certainly 
shown  that  men  may  live  and  thrive,  for  a  time 
at  least,  on  amounts  of  proteid  per  day  equal 
to  only  one-half  and  one-quarter  the  amount 
called  for  in  the  Voit  standard.  Siven's  experi- 
ments, in  particular,  certainly  indicate  that  the 
human  organism  can  maintain  itself  in  nitroge- 
nous equihbrium  with  far  smaller  amounts  of 
proteid  in  the  diet  than  is  ordinarily  taught,  and, 
further,  that  this  condition  can  be  attained  with- 
out unduly  increasing  the  total  calories  of  the 
food  intake.  Such  investigations,  however,  have 
always  called  forth  critical  comment  from  writers 
on  nutrition,  indicating  a  reluctance  to  depart 
from  the  current  doctrines  of  the  Voit  or  Munich 
6  [8.] 


T^he  A,B,-Z.  of  Our  Own  Nutrition 

school;  and,  indeed,  it  may  justly  be  claimed 
that  the  ordinary  nutrition  experiments,  extend- 
ing over  short  periods  of  time,  are  not  entirely 
adequate  to  prove  the  effect  of  a  given  set  of 
conditions  when  the  latter  are  continued  for 
months  or  years.  Thus,  Schafer  writes :  "  It 
may  be  doubted  whether  a  diet  which  includes 
considerably  less  proteid  than  lOO  grams  for  the 
twenty-four  hours  could  maintain  a  man  of 
average  size  and  weight  for  an  indefinite  time. 
It  has  frequently  been  asserted  that  many  Asi- 
atics consume  a  very  much  smaller  proportion 
of  proteid  than  is  the  case  with  Europeans. 
The  inhabitants  of  India,  Japan,  and  China 
chiefly  consume  rice  as  the  normal  constituent 
of  their  diet,  which  contains  relatively  little  pro- 
teid ;  and  this  has  been  advanced  as  an  argu- 
ment in  favour  of  the  view  that  the  minimal 
amount  of  proteid  is  much  less  than  that  ordi- 
narily given  as  essential  to  the  maintenance  of 
nutritive  equilibrium.  It  must,  however,  be 
stated  that  we  have  no  definite  statistics  to 
show  that,  in  proportion  to  their  body-weight, 
Asiatics  doing  the  same  amount  of  work  as 
Europeans  require  a  less  amount  of  proteids; 
indeed  such  evidence  as  is  forthcoming  is  rather 
in  favor  of  the  opposite  view."  This  statement 
is  typical  of  the  attitude  of  physiologists  in 
general  on  this  important  subject.      Why   not 

[82] 


T^he  A.B,-Z.  of  Our  Own  Nutrition 

candidly  admit  that  the  matter  is  in  doubt,  and, 
with  a  due  recognition  of  the  importance  of  the 
subject,  attempt  to  ascertain  the  real  truth  of 
the  matter? 

The  writer  has  had  in  his  laboratory  for 
several  months  past  a  gentleman  (H.  F.)  who 
has  for  some  five  years,  in  pursuit  of  a  study  of 
the  subject  of  human  nutrition,  practised  a  cer- 
tain degree  of  abstinence  in  the  taking  of  food 
and  attained  important  economy  with,  as  he  be- 
lieves, great  gain  in  bodily  and  mental  vigour, 
and  with  marked  improvement  in  his  general 
health.  Under  his  new  method  of  living  he  finds 
himself  possessed  of  a  peculiar  fitness  for  work 
of  all  kinds,  and  with  freedom  from  the  ordinary 
fatigue  incidental  to  extra  physical  exertion. 
In  using  the  word  abstinence  possibly  a  wrong 
impression  is  given,  for  the  habits  of  life  now 
followed  have  resulted  in  the  disappearance  of 
the  ordinary  craving  for  food.  In  other  words, 
the  gentleman  in  question  fully  satisfies  his  ap- 
petite, but  no  longer  desires  the  amount  of  food 
consumed  by  most  individuals. 

For  a  period  of  thirteen  days,  in  January, 
he  was  under  observation  in  the  writer's  labora- 
tory, his  excretions  being  analysed  daily  with  a 
view  to  ascertaining  the  exact  amount  of  proteid 
consumed.  The  results  showed  that  the  average 
daily  amount  of  proteid  metabolised  was  41.25 

[83] 


'^he  A.B,'Z.  of  Our  Own  Nutrition 

grams,  the  body-weight  (165  pounds)  remaining 
practically  constant.  Especially  noteworthy, 
also,  was  the  very  complete  utilisation  of  the 
proteid  food  during  this  period  of  observation. 
It  will  be  observed  here  that  the  daily  amount 
of  proteid  food  taken  was  less  than  one  half  that 
of  the  minimum  Voit  standard,  and  it  should  also 
be  mentioned  that  this  apparent  deficiency  in 
proteid  food  was  not  made  good  by  any  large 
consumption  of  fats  or  carbohydrates.  Further, 
there  was  no  restriction  in  diet.  On  the  con- 
trary, there  was  perfect  freedom  of  choice,  and 
the  instructions  given  were  to  follow  his  usual 
dietetic  habits.  Analysis  of  the  excretions 
showed  an  output  of  nitrogen  equal  to  the 
breaking  down  of  41.25  grams  of  proteid  per 
day  as  an  average,  the  extremes  being  33.06 
grams  and  47.05  grams  of  proteid. 

In  February  a  more  thorough  series  of  ob- 
servations was  made,  involving  a  careful  analy- 
sis of  the  daily  diet,  together  with  analysis  of 
the  excreta,  so  that  not  alone  the  proteid  con- 
sumption might  be  ascertained,  but  likewise  the 
total  intake  of  fats  and  carbohydrates.  The 
diet  consumed  was  quite  simple,  and  consisted 
merely  of  a  prepared  cereal  food,  milk,  and 
maple  sugar.  This  diet  was  taken  twice  a  day 
for  seven  days,  and  was  selected  by  the  subject 
as  giving  sufficient  variety  for  his  needs   and 

[84] 


T^he  A.B,-  Z.  of  Our  Own  Nutrition 

quite  in  accord  with  his  taste.  No  attempt  was 
made  to  conform  to  any  given  standard  of  quan- 
tity, but  the  subject  took  each  day  such  amounts 
of  the  above  foods  as  his  appetite  craved.  Each 
portion  taken,  however,  was  carefully  weighed 
in  the  laboratory,  the  chemical  composition  of 
the  food  determined,  and  the  fuel  value  calcu- 
lated by  the  usual  methods. 

The  following  table  gives  the  daily  intake  of 
proteids,  fats,  and  carbohydrates  for  six  days, 
together  with  the  calculated  fuel  value,  and  also 
the  nitrogen  intake,  together  with  the  nitrogen 
output  through  the  excreta.  Many  other  data 
were  obtained  showing  diminished  excretion  of 
uric  acid,  ethereal  sulphates,  phosphoric  acid, 
etc.,  but  they  need  not  be  discussed  here. 


Intake 

Output  of  Niuogen 

Proteids 

Fau 

Carbohy 

Calories 

r«trogen 

Urine 

Fa^res 

Total 

Grmms 

Grams 

Grams 

Grams 

Grams 

Grams 

Grams 

Feb 

.  2 

31-3 

25.3 

266.2 

900 

5.02 

.S27 

0.18 

5-45 

3 

46.8 

40.4 

l6qo 

7.  SO 

6.24 

0.8 1  <^ 

7.0s 

4 

48.0 

38.1 

283.0 

1747 

7.70 

5-53 

o.8i» 

6.34 

S 

50.0 

40.6 

269.0 

I7II 

8.00 

6.44 

0.81* 

7.2  s 

6 

47 -o 

41.5 

267.0 

1737 

749 

6.83 

0.81* 

7.64 

7 

46.5 

39.« 

307-3 

1852 

7-44 

7.50 

0.17 

7.67 

Daily 

Av. 

44.9 

38.0 

2530 

1606 

7.19 

6.30 

0.60 

6.90 

♦Average  of  the  four  days. 

The  main  things  to  be  noted  in  these  results 
are,  first,  that   the  total  daily  consumption  of 
proteid   amounted   on  an   average  to   only  45 
[8s] 


T^he  A.B,-  Z.  of  Our  Own  Nutrition 

grains,  and  that  the  fat  and  carbohydrate  were 
taken  in  quantities  only  sufficient  to  bring  the 
total  fuel  value  of  the  daily  food  up  to  a  little 
more  than  i  ,600  large  calories.  If,  however,  we 
eliminate  the  first  day,  when  for  some  reason 
the  subject  took  an  unusually  small  amount  of 
food,  these  figures  are  increased  somewhat,  but 
they  are  ridiculously  low  compared  with  the 
ordinarily  accepted  dietary  standards.  When 
we  recall  that  the  Voit  standard  demands  at 
least  118  grams  of  proteid  and  a  total  fuel  value 
of  3,000  large  calories  daily,  we  appreciate  at 
once  the  full  significance  of  the  above  figures. 
But  it  may  be  asked,  was  this  diet  at  all  adequate 
for  the  needs  of  the  body  —  sufficient  for  a  man 
weighing  165  pounds?  In  reply,  it  may  be  said 
that  the  appetite  was  satisfied,  and  that  the  sub- 
ject had  full  freedom  to  take  more  food  if  he  so 
desired.  To  give  a  physiological  answer,  it 
may  be  said  that  the  body-weight  remained 
practically  constant  throughout  the  seven  days' 
period,  and  further,  it  will  be  observed  by  com- 
paring the  figures  of  the  table  that  the  nitrogen 
of  the  intake  and  the  total  nitrogen  of  the  out- 
put were  not  far  apart.  In  other  words,  there 
was  a  close  approach  to  what  the  physiologist 
calls  nitrogenous  equilibrium.  In  fact,  it  will  be 
noted  that  on  several  days  the  nitrogen  output 
was  slightly  less  than  the  nitrogen  taken  in.  We 
[86  1 


T:'he  A,B,'  Z.  of  Our  Own  Nutrition  . 

are,  therefore,  apparently  justified  in  saying 
that  the  above  diet,  simple  though  it  was  in 
variety,  and  in  quantity  far  below  the  usually 
accepted  requirement,  was  quite  adequate  for 
the  needs  of  the  body.  In  this  connection  it 
may  be  asked,  what  were  the  needs  of  the  body 
during  this  seven  days'  period?  This  is  obvi- 
ously a  very  important  point.  Can  a  man  on 
such  a  diet,  even  though  it  suffices  to  keep  up 
body-weight  and  apparently  also  physiological 
equilibrium,  do  work  to  any  extent?  Will  there 
be  under  such  condition  a  proper  degree  of  fit- 
ness for  physical  work  of  any  kind  ?  In  order 
to  ascertain  this  point,  the  subject  was  invited 
to  do  physical  work  at  the  Yale  University 
Gymnasium,  and  placed  under  the  guidance  of 
the  director  of  the  gymnasium,  Dr.  William  G. 
Anderson.  The  results  of  the  observations 
there  made  are  here  given,  taken  verbatim  from 
Dr.  Anderson's  report  to  the  writer. 

On  the  4th,  5th,  6th,  and  7th  of  February,  1903, 1  gave 
to  Mr.  Horace  Fletcher  the  same  kind  of  exercises  we 
give  to  the  Varsity  Crew.  They  are  drastic  and  fatiguing 
and  cannot  be  done  by  beginners  without  soreness  and 
pain  resulting.  The  exercises  he  was  asked  to  take  were 
of  a  character  to  tax  the  heart  and  lungs,  as  well  as  to 
try  the  muscles  of  the  limbs  and  trunk.  I  should  not 
give  these  exercises  to  Freshmen  on  account  of  their 
severity. 

Mr.  Fletcher  has  taken  these  movements  with  an  ease 
that  is  unlooked  for.     He  gives  evidence  of  no  soreness 

[87] 


T^he  A,B,-Z,  of  Our  Own  Nutrition 

or  lameness,  and  the  large  groups  of  muscles  respond 
the  second  day  without  evidence  of  being  poisoned  by 
Carbon  dioxide.  There  is  no  evidence  of  distress  after 
or  during  the  endurance  test,  i.  e.,  the  long  run.  The 
heart  is  fast  but  regular.  It  comes  back  to  its  normal 
beat  quicker  than  does  the  heart  of  other  men  of  his 
weight  and  age. 

The  case  is  unusual,  and  I  am  surprised  that  Mr. 
Fletcher  can  do  the  work  of  trained  athletes  and  not  give 
marked  evidences  of  over-exertion.  As  I  am  in  almost 
constant  training  I  have  gone  over  the  same  exercises, 
and  in  about  the  same  way,  and  have  given  the  results 
for  a  standard  of  comparison.  [The  figures  are  not 
given  here.] 

My  conclusion,  given  in  condensed  form,  is  this : 
Mr.  Fletcher  performs  this  work  with  greater  ease  and 
with  fewer  noticeable  bad  results  than  any  man  of  his 
age  and  condition  I  have  ever  worked  with. 

To  appreciate  the  full  significance  of  this 
report,  it  must  be  remembered  that  Mr.  Fletcher 
had  for  several  months  past  taken  practically  no 
exercise  other  than  that  involved  in  daily  walks 
about  town. 

In  view  of  the  strenuous  work  imposed  dur- 
ing the  above  four  days,  it  is  quite  evident  that 
the  body  had  need  of  a  certain  amount  of  nutri- 
tive material.  Yet  the  work  was  done  without 
apparently  drawing  upon  any  reserve  the  body 
may  have  possessed.  The  diet,  small  though  it 
was,  and  with  only  half  the  accepted  require- 
ment in  fuel  value,  still  sufficed  to  furnish  the 
requisite  energy.  The  work  was  accomplished 
with  perfect  ease,  without  strain,  without  the 
[88] 


T^he  A.B.'Z,  of  Our  Own  Nutrition 

usual  resultant  lameness,  without  taxing  the 
heart  or  lungs,  and  without  loss  of  body- 
weight.  In  other  words,  in  Mr.  Fletcher's  case 
at  least,  the  body  machinery  was  kept  in  perfect 
fitness  without  the  consumption  of  any  such 
quantities  of  fuel  as  has  generally  been  consid- 
ered necessary. 

Just  here  it  may  be  instructive  to  observe 
that  the  food  consumed  by  Mr.  Fletcher  during 
this  seven  days*  period  —  and  which  has  been 
shown  to  be  entirely  adequate  for  his  bodily 
needs  during  strenuous  activity  —  cost  eleven 
cents  daily,  thus  making  the  total  cost  for  the 
seven  days  seventy-seven  cents  !  If  we  contrast 
this  figure  with  the  amounts  generally  paid  for 
average  nourishment  for  a  like  period  of  time, 
there  is  certainly  food  for  serious  thought.  Mr. 
Fletcher  avers  that  he  has  followed  his  present 
plan  of  living  for  nearly  five  years ;  he  usually 
takes  two  meals  a  day ;  has  been  led  to  a  strong 
liking  for  sugar  and  carbohydrates  in  general 
and  away  from  a  meat  diet ;  is  always  in  perfect 
health,  and  is  constantly  in  a  condition  of  fit- 
ness for  work.  He  practises  thorough  mastica- 
tion, with  more  complete  insalivation  of  the  food 
(liquid  as  well  as  solid)  than  is  usual,  thereby 
insuring  more  complete  and  ready  digestion  and 
a  more  thorough  utilisation  of  the  nutritive  por- 
tions of  the  food. 

[89] 


ne  A.B.-Z,  of  Our  Own  Nutrition 

In  view  of  these  results,  are  we  not  justified 
in  asking  ourselves  whether  we  have  yet  attained 
a  clear  comprehension  of  the  real  require- 
ments of  the  body  in  the  matter  of  daily  nutri- 
ment? Whether  we  fully  comprehend  the  best 
and  most  economical  method  of  maintaining  the 
body  in  a  state  of  physiological  fitness?  The 
case  of  Mr.  Fletcher,  just  described  ;  the  results 
noted  in  connection  with  certain  Asiatic  peoples ; 
the  fruitarians  and  «?//arians  in  our  own  country 
recently  studied  by  Professor  Jaffa,  of  the  Uni- 
versity of  California ;  all  suggest  the  possibility 
of  much  greater  physiological  economy  than  we 
as  a  race  are  wont  to  practise.  If  these  are 
merely  exceptional  cases,  we  need  to  know  it ; 
but  if,  on  the  other  hand,  it  is  possible  for  man- 
kind in  general  to  maintain  proper  nutritive 
conditions  on  dietary  standards  far  below  those 
now  accepted  as  necessary,  it  is  time  for  us  to 
ascertain  that  fact.  For,  if  our  standards  are 
now  unnecessarily  high,  then  surely  we  are  not 
only  practising  an  uneconomical  method  of  sus- 
taining life,  but  we  are  subjecting  ourselves  to 
conditions  the  reverse  of  physiological,  and 
which  must  of  necessity  be  inimical  to  our  well- 
being.  The  possibility  of  more  scientific  knowl- 
edge of  the  natural  requirements  of  a  healthy 
nutrition  is  made  brighter  by  the  fact  that  the 
economic  results  noted  in  connection  with  our 

L90] 


T^he  A,B.-  Z.  of  Our  Own  Nutrition 

metabolism  examination  of  Mr.  Fletcher  is  con- 
firmatory of  similar  results  obtained  under  the 
direction  and  scrutiny  of  Sir  Michael  Foster  at 
the  University  of  Cambridge,  England,  during 
the  autumn  and  winter  of  last  year ;  and  by  Dr. 
Ernest  Van  Someren,  Mr.  Fletcher's  collabora- 
teur^  in  Venice,  on  subjects  of  various  ages  and 
of  both  sexes,  some  account  of  which  has  already 
been  presented  to  the  British  Medical  Associa- 
tion and  to  the  International  Congress  of  Phys- 
iologists at  its  last  meeting  at  Turin,  Italy.  At 
the  same  time  emphasis  must  be  laid  upon  the 
fact  that  no  definite  and  positive  conclusions 
can  be  arrived  at,  except  as  the  result  of  careful 
experiments  and  observations  on  many  individ- 
uals covering  long  periods  of  time.  This,  how- 
ever, the  writer  hopes  to  do  in  the  very  near 
future,  with  the  cooperation  of  a  corps  of  inter- 
ested observers. 

The  problem  is  far-reaching.  It  involves  not 
alone  the  individual,  but  society  as  a  whole,  for 
beyond  the  individual  lies  the  broader  field  of 
the  community,  and  what  proves  helpful  for  the 
one  will  eventually  react  for  the  betterment  of 
society,  and  for  the  improvement  of  mankind  in 
general. 


[9'] 


INTRODUCTION  TO  DR.  HARRY  CAMPBELL'S 

CONTRIBUTION  ON  THE  IMPORTANCE 

OF   MASTICATION 

[Since  the  publication  of  Van  Someren's  paper,"  Was  Luigi 
Cornaro  Right?",  read  before  the  British  Medical  Associa- 
tion, and  reprinted  elsewhere  in  this  volume,  much  more 
attention  has  been  given  to  the  study  of  mastication  than  had 
been  previously  reported.  Mr.  Gladstone's  advice  to  his  chil- 
dren, which  was  commonly  current  and  was  repeated  when- 
ever mastication  was  mentioned,  was  usually  accompanied  and 
met  by  an  amused  smile  that  showed  that  the  full  importance 
of  better  mouth-treatment  of  food  was  not  appreciated.  Glut- 
ton or  Epicure,  a.  little  book  by  the  present  writer,  published 
in  1898,  insisted  on  thorough  use  of  the  functions  of  the  mouth 
in  alimentation  but  did  not  go  into  the  anatomical,  physiologi- 
cal and  dental  details. 

Dr.  Harry  Campbell  of  Northwest  London  Hospital  has  per- 
formed this  latter  service  to  science  and  humanity,  with  splen- 
did carefulness,  and  must  have  devoted  much  time  and  study 
to  the  collection  of  evidence  and  suggestion  which  is  given 
here  following  in  full,  reprinted  from  the  London  Lancet. 

The  authors  acknowledge  with  much  gratitude,  the  court- 
eous permission  of  both  Dr.  Campbell  and  of  the  editor  of  the 
Lancet,  to  reprint  all  four  articles  which  composed  the  series. 

In  our  own  study  of  the  subject  of  mouth-treatment  of  food 
we  have  been  led  to  give  more  credit  to  the  chemical  feature 
of  preparation  than  Dr.  Campbell  yet  attributes  to  the  chemi- 
cal side  of  the  problem.  Comminution  of  hard  food  is  of 
first  importance,  undoubtedly,  but  insalivation  and  neutralisa- 
tion or  alkalinisation  are,  seemingly,  much  more  easily  and 
quickly  accomplished  in  the  mouth  than  farther  on  in  the 
alimentary  canal.  The  intestines  can  do  all  in  the  way  of 
digestion,  even  if  the  mouth  and  stomach  are  passed  and  their 
assistance  in  the  digestive  process  is  entirely  neglected,  but  it 
is  done  at  tremendous  disadvantage  in  the  supplementary 
digestive  tract  of  the  intestines.     We  have  proven  the  econ- 

[9*] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

omy  of  letting  the  mouth  do  all  it  can,  by  the  insalivation 
(sipping  and  tasting)  of  liquids  that  have  taste  up  to  the  point 
of  compulsory  swallowing  (a  sucking-up  by  the  Swallowing 
Impulse  which  naturally  occurs  in  the  course  of  treatment 
in  the  mouth  if  not  fought  against  too  strongly).  If  Dr. 
Campbell  will  extend  his  observations  to  liquids,  say  milk, 
and  for  a  sufficiently  long  time  to  measure  results  by  con- 
tinued economy  of  assimilation  and  saving  of  solid  excreta,  he 
will  find  that  it  pays  to  let  the  mouth  do  all  it  can  do,  and  that 
while  it  cannot  do  too  much  it  may  do  too  little.  The  natural 
instincts  of  the  mouth,  or  those  that  attach  to  the  mouth, 
become  much  more  discriminating  also  if  exercised  on  liquids 
as  well  as  on  solids.  This  they  do  not  learn  to  do  so  well 
if  sapid  liquids  are  habitually  rushed  past  their  field  of 
discrimination. 

Taste  enjoyed  in  the  mouth  is  good,  and  a  good  part  of  the 
pleasure  of  living  comes  from  taste  gratification,  but  taste  that 
returns  from  the  stomach  and  is  belched  by  eructation  or  is 
lingeringly  reminiscent  in  the  mouth  or  nose  is  indicative  of 
indigestion. 

Hence  it  is  better  to  dissipate  taste  in  the  mouth,  which  is 
the  sole  region  of  taste.  Spirits  tasted  into  absorption  in  this 
way  leave  no  odour  upon  the  breath,  and  asparagus  munched 
and  tasted  to  the  limit  in  the  mouth,  carries  no  odour  to  the 
urine.  Even  the  stale  and  disagreeable  odour  of  onion  or 
garlic  can  be  neutralised  by  saliva  and  killed  in  the  mouth. 

It  is  extremely  diflficult  to  get  observers  to  practise  tasting 
taste  out  of  liquids  as  the  wine  tasters  do,  and  as  the  tea 
tasters  have  to  do  or  die ;  or,  at  least,  become  useless  in  their 
profession.  Once  the  efiicacy  of  the  liquid-tasting  precaution 
in  digestion  is  understood,  however,  to  swallow  anything  but 
pure  water  without  tasting  it  into  absorption  produces  a  shock. 
This  care  becomes  instinctive  quite  easily  and  regulates  itself 
automatically.  It  is  also  a  distinct  gain  to  the  gustatory  pos- 
sibilities, which  are  very  limited  at  best. 

When  the  body  will  tolerate  spirits  tasted  into  it  —  not 
poured  into  it  —  at  all,  which  is  not  often  when  the  nutrition 
is  normal  (only  in  damp  or  cold  weather,  as  a  general  thing, 
and  then  in  the  case  of  the  writer  only  at  rare  intervals,  say 
two  or  three  times  a  year),  the  spirit  will  mix  quickly  with  the 
saliva  and  become  neutralised  sufficiently  to  excite  the  Swad- 

[93] 


The  A,B,-Z,  of  Our  Own  Nutrition 

lowing  Impulse.  Continue  sipping  the  spirit  for  a  time  and 
you  will  note  that  there  comes  a  point  where  the  saliva  and 
the  spirit  do  not  mix,  do  not  neutralise ;  the  mouth  becomes 
unduely  full  of  liquid  without  any  relaxation  or  invitation  of 
the  Swallowing  Impulse;  and  the  really  instinctive  inclina- 
tion will  be  to  spit  it  out.  It  is  a  clear  indication  that  the 
hody-toleration  has  been  fully  taxed;  there  is  no  longer  any 
bodily  need  for  alcohol  —  in  fact,  there  is  no  longer  natural 
toleration  —  and  the  secretion  sent  down  into  the  mouth  is 
evidently  mucous  for  a  washing-out  process,  and  is  not  alka- 
line saliva  for  assisting  in  a  utilisation  function. 

It  is  quite  uncanny  to  observe  the  nicety  of  mouth-discrimi- 
nation and  the  consistency  of  it  as  related  to  similar  substances 
under  similar  conditions,  if  one  learn  to  read  it  with  precision 
and  intelligence. 

With  increased  ease  of  digestion,  which  comes  with  more 
thorough  attention  to  solid  foods  alone,  the  ordinary  observer 
will  think  that  he  has  accomplished  the  whole  of  the  possible 
benefit.  It  is  only  when  he  gives  sufficient  time  to  liquids 
also,  to  get  the  added  delight  and  relief  that  salivary  respect 
of  them  brings,  that  the  whole  of  the  beneficence  of  mouth- 
service  is  realised.  Follow  this  discrimination  and  care  to  a 
comparative  measurement  of  the  waste  of  digestion,  the  solid 
excreta,  and  note  the  increased  proportionate  gain  in  assimi- 
lation and  the  value  of  the  economy  will  be  appreciated.  Try 
the  different  treatments  on  milk  for  a  month ;  fifteen  days 
with  drinking  and  fifteen  days  insalivating  (sipping  and  tasting) 
the  milk  to  the  limit,  and  keep  account  of  quantity  of  intake 
required  to  satisfy  appetite  and  maintain  body-weight;  and 
also  note  carefully  the  condition  and  quantity  of  the  faeces. 
In  the  one  case  you  will  find  the  waste  to  hefceces  indeed,  and 
unmistakably  worthy  of  the  name ;  but  in  the  case  of  sipping, 
tasting  and  insalivating  the  milk  to  the  full  satisfaction  of  the 
appetite,  the  digestion-ash  will  assume  quite  a  different  amount 
and  character  and  deserve  a  change  of  name.  The  propor- 
tions of  the  saving  in  our  own  experiments  have  approximated 
the  difference  between  three  and  ten ;  that  is,  on  a  reduction 
of  only  one-third  the  quantity  of  food  commonly  ingested, 
but  fully  satisfying  the  sipping  and  tasting  appetite,  the  quan- 
tity of  solid  excreta  was  only  one-tenth  of  the  other  and  of 
quite  a  different  character,  aesthetically  considered. 

[94] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

While  these  suggestions  do  not  discredit  or  affect  the  value 
of  the  purely  mechanical  side  of  the  treatment  as  given  by  Dr. 
Campbell,  and  are  not  intended  to  be  controversial,  they  are 
ventured  as  an  amendment  to  be  worked  out  in  regard  to 
liquids,  which  are,  in  fact,  only  an  extreme  of  the  pultaceous 
foods  against  which  Dr.  Campbell  warns  us  as  being  subtly 
dangerous. 

There  is  another  point  in  our  experiences  and  observations 
of  the  largest  importance  that  may  appropriately  be  intro- 
duced here:  The  treatment  of  all  liquids  in  the  manner  sug- 
gested prevents  intemperance  of  drinking  as  effectively  as  it 
does  intemperance  of  eating. 

When  food  is  filtered  into  the  body  after  having  become 
liquified  and  made  alkaline,  or,  at  least  neutral,  by  saliva,  the 
appetite  is  given  a  chance  to  measure  the  needs  of  the  body 
and  to  discriminate  against  excess.  As  soon  as  the  point  of 
complete  saturation  of  any  one  deficiency  is  reached,  the 
appetite  is  cut  off,  as  short  as  possible  to  imagine,  with  no 
indication  of  stomach  fullness.  It  will  welcome  a  little  of 
proteid  in  beans,  cheese,  eggs,  or  in  some  other  of  its  richer 
forms,  and  then  turn  to  sugar  or  fat  in  some  of  their  numer- 
ous forms.  Thirst  for  water  will  assert  itself  for  a  moment, 
sometimes  asking  but  for  a  drop  and  again  for  a  full  glass, 
and  afterwards,  when  near  the  point  of  complete  saturation, 
appetite  will  hesitate  for  a  moment,  as  if  searching  around 
for  some  rare  substance,  and  may  find  its  final  satisfaction  in 
a  single  spoonful  of  a  sweet  or  a  sip  of  something  in  sight. 

The  appetite  satisfied  by  the  infiltering  process  is  a  sweetly 
appeased  appetite,  calm,  rested,  contented,  normal.  There 
is  no  danger  from  the  flooding  of  intemperance,  for  there  is 
not  even  toleration  of  excess  either  of  more  food  or  of  more 
drink,  and  this  contented  appetite  will  remain  in  the  condition 
of  contentment  until  another  need  has  really  been  earned  by 
evaporation  or  destructive  katabolism. 

In  the  teaching  of  this  physiology  and  psychology  of  ali- 
mentation to  the  children  of  England,  lies  the  only  true  solu- 
tion of  the  drink  question,  which  is  now  the  curse  of  the 
nation. 

Dr.  Campbell  has  made  such  a  splendid  case  for  the  mechan- 
ical side  of  mouth  work,  that  it  is  the  hope  of  the  writer  that 
he  will  give  equally  careful  consideration  to  the  chemical  and 

[95] 


T'he  A,B,'Z,  of  Our  Own  Nutrition 

psychological  sides,  and  in  a  completeness  of  observation 
render  inestimable  service  to  his  country,  to  science,  and 
humanity.  A  decade  of  trial  on  the  inmates  of  an  infant 
orphan  asylum  will  show  the  possibilities  for  the  nation  in  a 
single  generation,  if  broadly  applied.  It  might  lead  to  an 
effective  intemperance,  inhibition,  or  quarantine,  and  that  is 
all  any  nation  needs  of  advantage  to  make  it  independent  of 
the  world  and  truly  great.  —  Horace  Fletcher.] 


OBSERVATIONS   ON   MASTICATION 

By  Harry  Campbell,  M.D.,  F.R.C.P.  (Lond.) 

Physician  to  the  Northwest  London  Hospital 

[London  Lancet,  July  ii,  i8,  25,  and   August   8,  1903] 

Section  I.     From  London  Lancet,  July  11,  1903 

The  Effects  of  Mastication 
The  primary  object  of  mastication  is  to 
break  up  the  food  so  as  (i)  to  facilitate  the 
swallowing  of  it,  and  (2),  still  more  important, 
to  insure  its  intimate  admixture  with  the  diges- 
tive juices,  not  only  within  the  mouth,  but 
throughout  the  entire  digestive  tract.  Masti- 
cation has,  however,  other  important  and  far- 
reaching  effects.  Thus  it  promotes  the  flow  of 
saliva  and,  when  properly  performed,  secures  a 
due  insalivation  of  the  food ;  it  increases  the 
quantity  of  alkaline  saliva  passing  into  the  stom- 
ach ;  it  stimulates  the  heart  and  circulation ; 
and  it  finally  influences  the  nutrition  of  the  jaws 
and  their  appendages  by  stimulating  the  local 

[96] 


^he  A.B.'Z,  of  Our  Own  Nutrition 

blood  and  lymph  circulation.     Now  to  consider 
these  various  objects  and  effects  of  mastication. 

Mastication  facilitates  swallowing.  —  Many- 
foods  cannot  be  swallowed  without  first  going 
through  some  preparation  in  the  mouth.  Soft, 
moist,  pultaceous  foods,  such  as  milk  pudding 
and  porridge,  can  be  and  often,  indeed,  are  swal- 
lowed with  little  or  no  preliminary  chewing.  On 
the  other  hand,  it  is  a  mechanical  impossibility 
to  swallow  large  lumps  of  tough  food,  or  very 
dry  food,  even  though,  like  flour,  it  be  in  a  finely 
divided  state.  Dry  food  needs  first  to  be  well 
moistened ;  and  it  is  not  surprising  that  it  pro- 
motes a  more  abundant  flow  of  saliva  than  moist 
food,  though  the  secretion  thus  excited  may  be 
poor  in  ferment.  Hence  it  follows  that  if  we 
desire  to  give  foods  which  compel  mastication, 
they  should  be  tough  or  dry.  On  the  whole, 
vegetable  foods  necessitate  more  thorough  masti- 
cation than  animal.  The  carnivora  can  scarcely 
be  said  to  masticate  at  all  the  flesh  which  they 
consume;  they  simply  tear  off  portions,  and 
forthwith  swallow  them  whole.  Cooked  flesh, 
however,  does  require  mastication,  owing  to  the 
coagulation  of  its  proteids.  The  herbivora,  on 
the  other  hand,  unlike  the  carnivora,  have  to 
subject  their  food  to  considerable  mastication 
before  it  can  be  swallowed ;  but  they  generally 
masticate  it  far  more  than  is  needful  to  render 
7  [97] 


The  A,B,-Z,  of  Our  Own  Nutrition 

swallowing  mechanically  possible,  as  is  exempli- 
fied in  the  act  of  rumination,  the  object  here 
being  to  facilitate  the  admixture  of  the  digestive 
juices  with  the  food. 

According  to  Van  Someren,  if  the  habit  of 
masticating  efficiently  is  once  acquired,  the  food 
is  not  swallowed  before  it  is  converted  into  the 
liquid  state,  the  swallowing  of  unmasticated 
lumps  being  effectually  prevented  by  a  pharyn- 
geal reflex. 

Mastication^  by  breaking  the  food  up  i^tto  small 
particles^  enables  it  to  be  brought  into  intimate  con- 
tact with  the  digestive  jinces.  —  Such  comminu- 
tion is  especially  needful  in  the  case  of  raw 
vegetable  foods  of  the  tougher  kind,  in  order  to 
break  up  their  cellulose  framework,  and  to  set 
free  the  contained  starch,  proteids,  and  fats. 
Foods  of  this  kind,  unless  masticated,  yield  prac- 
tically no  nutriment  to  the  organism.  I  cannot 
too  strongly  emphasise  the  fact  that  before  man 
learned  to  break  up  the  cellulose  framework  of 
his  vegetable  food  by  cooking  he  was  compelled 
to  subject  it  to  laborious  mastication.  But,  while 
thorough  comminution  is  especially  needed  for 
vegetable  food  when  raw,  it  is  also  needed  for 
many  cooked  forms  of  it  also,  —  as,  for  exam- 
ple, solid  batter  pudding  and  new  underbaked 
bread,  heavy  lumps  of  which,  passing  into  the 
stomach,  may  seriously  hamper  the  work  of  that 

[98] 


T^he  A.B.'  Z.  of  Our  Own  Nutrition 

organ.  Such  substances  are  indigestible  essen- 
tially by  virtue  of  their  impermeability  to  the 
digestive  juices,  and  they  gain  in  digestibility  in 
proportion  as  they  are  comminuted.  The  indi- 
gestibihty  of  new  bread  would  appear  to  be 
wholly  due,  not  to  any  peculiarity  of  chemical 
composition,  but  to  its  tendency  to  elude  the 
teeth  and  form  a  sodden  mass  impermeable  to 
the  digestive  juices,  while  the  more  powdery 
stale  bread  is  more  easily  broken  up  both  in 
the  mouth  and  within  the  stomach.  Cabbage, 
again,  owes  its  indigestibility  to  the  fact  that  it 
is  allowed  to  pass  into  the  stomach  in  large 
masses,  while  the  well-known  digestibility  of 
cauliflower  and  minced  spinach  is  due  to  the  fine- 
ness of  their  division ;  were  cabbage  as  finely 
minced  as  spinach  usually  is  it  would  be  equally 
digestible. 

Turning  now  to  animal  food  it  has  to  be  re- 
marked that  while  in  the  raw  state  it  may  be 
readily  digestible  with  little  or  no  previous  mas- 
tication, since  massive  pieces  of  it  are  readily 
attacked  by  the  digestive  juices,  the  like  is 
much  less  true  of  animal  food  the  proteids  of 
which  have  been  coagulated  and  rendered  less 
permeable  by  cooking.  Large  lumps  of  hard- 
boiled  Qgg  or  overdone  meat,  for  instance,  may 
obstinately  resist  gastric  digestion;  indeed,  as 
with  vegetable  so  with  animal  foods,  their  rela- 

[99] 


'The  A,  B,-Z.of  Our  Own  Nutrition 

live  digestibility  depends  more  upon  physical 
consistence  than  chemical  composition ;  beef  is 
generally  more  indigestible  than  mutton  and 
pork  or  veal  than  either,  not  so  much  by  virtue 
of  chemical  composition  as  of  physical  consist- 
ence; the  indigestibility  of  cheese  illustrates 
the  same  truth;  the  individual  nutritive  ingre- 
dients of  this  substance  —  the  proteids  and  fats 
—  are  not  in  themselves  indigestible ;  casein  in 
the  form  of  protein  or  plasmon  is  known  to  be 
rcasy  of  digestion,  and  butter  is  one  of  the  most 
digestible  of  fats;  but  in  cheese  the  two  are 
welded  together  into  a  comparatively  imperme- 
able mass,  which  is  apt  to  escape  comminution 
by  the  teeth  and  to  pass  down  into  the  stomach 
in  the  form  of  solid  lumps.  A  plain,  wholesome 
cheese  well  masticated  or  intimately  mixed  with 
other  foods,  as  in  macaroni  cheese,  is  quite 
easily  digested  by  the  majority. 

I  do  not,  of  course,  deny  the  influence  of 
the  chemical  factor.  Undoubtedly  food  may 
disturb  digestion  by  virtue  of  its  chemical  com- 
position, apart  altogether  from  its  physical  char- 
acters; thus,  while  cooked  goose-fat  sets  up 
violent  irritation  in  some,  others  cannot  tolerate 
eggs  in  any  shape  or  form,  and  innumerable 
idiosyncrasies  in  respect  of  special  articles  of 
diet  are  met  with  which  are  essentially  referable 
to  chemical  composition;  but  making  due  al- 
[loo] 


The  A, B,-Z,of  Our  G'Wh  Nutriiian'  ■ ' 

lowance  for  this  chemical  influence  there  can,  I 
think,  be  little  doubt  that  the  digestibility  of  the 
more  common  articles  of  diet,  both  animal  and 
vegetable,  depends  in  the  main  upon  their  phy- 
sical constitution,  all  of  them  ^tending  to  be 
equally  digestible  when  reduced  to  the  same  de- 
gree of  comminution.  This,  if  true,  is,  I  need 
scarcely  say,  a  fact  of  the  greatest  practical  im- 
portance, for  it  amounts  to  this:  that  we  may 
often  allow  to  those  with  very  weak  digestions 
foods  which  are  generally  considered  indigestible, 
provided  that  they  be  thoroughly  comminuted, 
whether  by  mastication  or  artificial  means. 

Mastication  promotes  the  flow  of  saliva  and  the 
insalivation  of  the  food.  —  The  more  efficiently 
food  is  masticated  the  greater  is  the  salivary  flow, 
and  the  more  intimately  is  it  mixed  with  the 
saliva,  or,  as  we  say,  insalivated.  The  saliva 
has  apparently  no  effect  on  fats ;  whether  it  acts 
on  proteids  seems  more  doubtful,  though  by 
some  authorities  the  penetration  of  these  by  the 
alkali  of  this  fluid  is  said  to  aid  in  their  subse- 
quent digestion ;  on  starch,  however,  the  saliva 
acts  very  potently,  and  hence  mastication  plays 
a  special  part  in  promoting  the  digestion  of 
starchy  foods.  Indeed,  if  only  mastication  be 
persisted  in  long  enough,  starch  may  be  wholly 
converted  into  maltose  within  the  mouth,  and  it 
need   scarcely  be  said  that  it  is  better  for  the 

[lOl] 


T/fe  A.  Br-  Z,  of  Our  Own  Nutrition 

individual  himself  to  manufacture  his  maltose  in 
this  way  than  that  he  should  take  it  ready  made 
for  him  in  the  form  of  one  of  the  many  **  malt 
extracts"  on  the  market.  Patients  are  often 
forbidden  starchy  food,  while  they  are  allowed 
the  maltose  which  they  can  quite  well  manufac- 
ture in  their  own  mouths.  Provided  they  be 
sufficiently  insalivated,  there  are  few  starchy 
foods  which  are  indigestible,  not  even  excepting 
the  proverbially  indigestible  new  potato.  These 
remarks  are  especially  applicable  to  children,  as 
will  be  more  particularly  insisted  on  later. 

Mastication  increases  the  amount  of  alkaline 
saliva  passing  into  the  stomachy  and  this  not  only 
prolongs  the  period  of  starch  digestion  within 
this  organ  but,  by  its  influence  upon  the  reaction 
of  the  gastric  contents,  influences  all  the  diges- 
tive processes  taking  place  there.  I  shall  have 
occasion  to  point  out  later  that  a  deficient  supply 
of  alkaline  saliva  in  the  stomach  predisposes  to 
certain  forms  of  indigestion. 

Mastication  acts  rejlexly  upon  the  stomach,  — 
It  is  now  known  that  the  act  of  mastication 
influences  the  stomach  reflexly,  promoting  the 
flow  of  gastric  juice  and  thus  preparing  the  stom- 
ach for  the  entrance  of  food  into  it.  If  the 
oesophagus  of  a  dog  is  cut  so  as  to  allow  the 
swallowed  food  to  escape  instead  of  passing  into 
the  stomach,  it  is  found  that  the  mastication  of 
[102] 


The  A,B.-Z.  of  Our  Own  Nutrition 

food  causes  a  considerable  flow  of  gastric  juice. 
Food  introduced  into  the  stomach  unaccom- 
panied by  mastication  is  less  effective  in  promot- 
ing the  gastric  flow.  It  is  probable  that  the 
influence  of  mastication  on  the  flow  of  gastric 
juice  is  largely  produced  through  the  medium 
of  psychic  influences,  for  the  more  efficient 
the  mastication  the  more  is  the  sense  of  taste 
affected. 

Mastication  stimulates  the  heart  and  so  pro- 
motes the  general  circulation,  —  This  stimulating 
action  may  be  partly  due  to  its  local  action  on 
the  flow  of  blood  and  lymph  in  the  jaws  and 
accessory  parts,  and  partly  to  a  reflex  influence, 
but  whatever  the  explanation  there  can  be  no 
doubt  of  the  fact.  Hence  the  mere  chewing  of 
a  non-nutritive  substance,  such  as  gum  arabic, 
is  stimulating,  and,  doubtless,  the  stimulating 
effects  induced  by  the  chewing  of  such  articles 
as  tobacco  and  betel  are  largely  to  be  explained 
in  this  way. 


The  Influence  of  Mastication  on  the 
Jaws  and  Adjacent  Structures 

This  subject  is  of  such  importance  that  it 

needs   to   be    dealt   with   in    some    detail.     By 

"  adjacent   structures "  I  mean  the  masticatory 

muscles,  tongue,  teeth,  salivary  glands,  the  nasal 

[103] 


7he  A.B.-Z,  of  Our  Own  Nutrition 

passages   and    sinuses   pertaining   thereto,   the 
naso-pharynx,  soft  palate,  and  tonsils. 

The  muscles  of  mastication.  —  Let  me  at 
the  outset  draw  attention  to  certain  anatomical 
points,  in  connection  with  the  muscles  of  masti- 
cation. These  are  (a^  their  massiveness;  (^) 
the  very  close  relation  of  the  pterygoids  to  the 
naso-pharynx ;  and  (c)  the  outward  direction  of 
the  pterygoids. 

(a)  It  is  not  until  one  studies  the  muscles 
of  mastication  closely  that  one  comes  to  realise 
their  massiveness.  Their  large  size,  in  relation 
to  the  bony  structures  in  connection  with  them, 
is  well  shown  in  a  vertical  transverse  section  of 
the  head  carried  through  the  ascending  ramus 
of  the  mandible^  (see  Fig.  i).  It  is  evident 
that  the  functional  activity  of  so  large  a  mass 
of  muscle  tissue  cannot  but  exercise  consider- 
able influence  on  the  nutrition  of  the  neighbour- 
ing parts. 

(b)  The  pterygoid  muscles,  springing  as 
they  do  from  the  internal  pterygoid  plates,  must 
necessarily  be  in  close  relation  with  the  naso- 
pharynx, especially  the  internal  pair,  which 
take  their  origin  from  the  internal  aspect  of  the 
internal  plates.  I  would  further  point  out  that 
the  external  pair,  although  they  diverge  from 

1  Dental  surgeons  now  speak  of  the  upper  jaw  as  the  max- 
illa, and  of  the  lower  jaw  as  the  mandible. 

[  104  ] 


T^he  A.B-Z,  of  Our  Own  Nutrition 


Temporal. 

Ext. 
pterygoid. 

Masseter. 


Int. 
pterygoid. 


Epiglottis. 


Figure  i. — Vertical  transverse  (slightly  oblique)  section  through 
the  head  on  a  level  with  the  epiglottis.  The  massiveness  of  the 
system  of  masticatory  muscles  is  apparent. 


[i°5] 


T^he  A,B,-Z.  of  Our   Own  Nutrition 

the  naso-pharynx  on  their  way  to  the  mandib- 
ular condyles,  yet  remain  on  a  level  with  that 
cavity.  This  close  relation  of  the  pterygoids 
to  the  naso-pharynx  is,  if  I  mistake  not,  of 
great  importance  in  relation  to  the  etiology 
of  "  adenoids." 

(^)  Of  the  two  pairs  of  pterygoids  the  ex- 
ternal pair  pass  in  the  more  outward  direction, 
forming  with  the  sagittal  plane  of  the  head 
an  angle  of  45°  (see  Figs,  i  and  2).  In  con- 
sequence of  this  direction  they  tend  by  their 
contraction  to  pull  the  pterygoid  plates  and 
posterior  parts  of  the  maxilla  away  from  the 
sagittal  plane  of  the  head,  and  thus  to  secure 
the  normal  width  of  the  posterior  nares.  It 
is  these  muscles  which  bring  about  the  lateral 
movements  of  the  mandible,  causing  the  lower 
teeth  to  move  laterally  and  sagitally  across  the 
upper,  the  food  being  in  this  way  far  more  ef- 
fectually ground  than  by  a  mere  vertical  pres- 
sure of  the  teeth  against  one  another.  These 
lateral  movements  are,  as  we  shall  see,  less 
pronounced  among  the  moderns  than  among 
primitive  peoples. 

The  influence  of  the  contraction  of  the  masti- 
catory muscles  on  the  local  circulation  of  blood  and 
lymph,  —  When  a  muscle  is  at  rest  the  blood 
[106] 


The  A.B,-Z,  of  Our  Own  Nutrition 


Malar  bone. 


TemporaL 

Masseter. 

Ext. 
pterygoid. 


Tensor    Levator     Int. 
palati.      palati.  pterygoid. 

Figure  2.  —  Portion  of  horizontal  section  of  head  about  an  inch 
below  the  condyles  of  the  lower  jaw.  The  out¥rard  direction  of 
the  external  pterygoids  is  well  shown ;  also  the  close  relation  <rf 
the  levatores  and  tensores  palati  with  the  internal  pterygoids. 


[107] 


The  A.B.-  Z,  of  Our  Own  Nutrition 

flows  sluggishly  through  it,  while  there  is  a  com- 
plete, or  all  but  complete,  stagnation  of  the  lymph 
current;  if  a  lymphatic  trunk  of  a  limb  at  rest 
be  cut  no  lymph  escapes  from  it.  Rhythmic 
muscle  contractions,  however,  stimulate  the  flow 
both  of  blood  and  lymph  (^),  in  the  contracting 
muscles  themselves  and  {b)  in  the  neighbouring 
parts,  {a)  Not  only  are  the  muscle  arteries 
dilated  during  rhythmic  contractions,  but  the 
blood  is  vigorously  squirted  out  of  the  muscle 
veins,  so  that  much  more  blood  flows  through 
a  muscle  during  its  rhythmic  contraction  than 
during  rest.  The  flow  of  lymph  is  even  more 
markedly  stimulated, — this  fluid,  which,  while  the 
muscle  is  at  rest,  is  stagnant  or  all  but  so,  being 
during  contraction  driven  actively  along  the 
lymphatic  trunks,  (b)  How  greatly  rhythmic 
muscle  contractions  influence  the  circulation  of 
fluids  in  the  neighbouring  parts  is  shown  by  the 
flushing  of  the  skin  and  the  swelling  of  the  soft 
parts  generally  of  a  limb  which  is  being  exer- 
cised. We  thus  see  how  profoundly  the  exer- 
cise of  the  masticatory  muscles  —  and  among 
these  we  must  not  forget  to  include  the  tongue 
—  influences  not  only  their  own  nutrition  but 
that  of  the  important  structures  adjacent  to 
them  —  that  is  to  say,  of  the  jaw-bones,  salivary 
glands,  buccal  mucous  membrane,  soft  palate, 
faucial  tonsils,  pharynx,  and  naso-pharynx,  as 
[io8] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

well  as  of  the  nasal  cavities  and  their  accessory 
sinuses.  All  these  parts  are  during  mastication 
copiously  flushed  with  blood  and  lymph,  from 
which  it  is  evident  that  efficient  mastication 
must  stimulate  their  nutrition  and  favour  their 
proper  development.  Hence,  in  one  who  has 
from  childhood  upwards  been  accustomed  to 
masticate  efficiently,  we  generally  find  these  parts 
well  developed,  the  jaws  large  and  shapely,  the 
teeth  regular  and  straight,  the  tongue  and  sali- 
vary glands  large,  the  nasal  and  naso-pharyngeal 
passages  spacious,  and  the  mucous  membrane 
of  the  buccal  and  adjoining  cavities  healthy. 

Influence  of  mastication  on  the  jaw-hones. — 
It  is  well  known  that  the  size  of  a  bone  is  largely 
determined  by  the  degree  to  which  the  muscles 
attached  to  it  are  exercised.  That  the  jaws  do 
not  grow  to  their  normal  size,  if  not  adequately 
exercised  during  their  period  of  growth,  is  strik- 
ingly shown  by  the  overcrowding  of  the  teeth, 
which  takes  place  in  those  brought  up  on  soft 
foods,  and  this  even  though  there  be  no  contrac- 
tion of  the  jaws  resulting  from  mouth-breathing. 
The  dependence  of  the  size  of  the  jaws  upon 
the  degree  to  which  they  are  exercised  is  also 
shown  by  the  smallness  of  the  modern  jaw,  as 
compared  with  that  of  primitive  peoples,  a  dif- 
ference which,  as  we  shall  see,  is  in  part  con- 
genital and  in  part  due  to  the  comparative 
[  109] 


The  A,B,-Z,  of  Our  Own  Nutrition 

disuse  of  the  former.  Mastication  influences  not 
only  the  size  but  also  the  shape  of  the  jaws  (^), 
through  its  influence  on  the  size  of  the  tongue, 
which  by  pressing  against  the  teeth  tends,  as 
Sim  Wallace  has  shown,  to  expand  the  jaws; 
(b)  by  the  pressure  of  opposing  teeth  against 
one  another,  which  has  a  similar  effect;  and 
{c)  by  the  outward  pull  of  the  pterygoids,  which 
tends  to  widen  the  maxilla  posteriorly  and  to 
broaden  the  posterior  nares. 

Influence  of  mastication  on  the  teeth.  —  The 
teeth  being  developed  within  the  jaw-bones  and 
remaining,  even  after  eruption,  in  close  anatom- 
ical and  physiological  association  with  them, 
must  necessarily  share  in  their  nutritive  ten- 
dencies. If  these  bones  are  efficiently  exercised 
during  the  formation  of  the  teeth  —  and  my  re- 
marks apply  especially  to  the  permanent  set  — 
the  tooth-germs  will  be  abundantly  flushed  with 
blood,  while  the  ample  growth  of  the  jaws  them- 
selves will  provide  the  germs  with  plenty  of  room 
in  which  to  grow  and  to  develop,  and  the  more 
perfect  their  growth  and  development  the  more 
resistant  should  we  expect  them  to  be  to  the 
ravages  of  caries.  Who  can  contemplate  the 
jaw-bones  of  a  six-years-old  child,  dissected  so 
as  to  display  all  the  imbedded  teeth,  without 
being  assured  of  the  effect  of  mastication  upon 
dental  development?  Fifty-two  teeth  meet  the 
[no] 


T:'he  A.  B,-  Z.of  Our  Own  Nutrition 

view :  the  whole  region  from  the  orbital  rims  to 
the  inferior  border  of  the  mandible  is  literally 
paved  with  them,  and  I  can  hardly  doubt  that 
they  collectively  weigh  more  than  the  bone  in 
which  they  are  imbedded.  Surely  no  one  can 
examine  such  a  dissection  without  being  con- 
vinced of  the  urgent  necessity,  if  the  teeth  are 
to  grow  and  to  develop  normally,  of  giving  the 
child's  jaws  from  infancy  onwards  plenty  of 
work  to  do. 

The  ample  development  of  the  jaws,  which 
efficient  mastication  brings  about,  has  a  further 
beneficial  effect  as  regards  the  teeth,  in  that  it 
enables  them  to  take  up  their  proper  places  in 
the  alveolar  ridges,  thus  securing  all  the  advan- 
tages of  a  good  "  bite."  These  I  now  proceed 
to  consider.  The  teeth  during  mastication,  and 
especially  when  the  bite  is  good  and  the  food 
of  a  kind  necessitating  vigorous  and  sustained 
mastication,  are  made  to  move  in  their  sockets 
both  vertically  and  horizontally;  the  effect  of 
this  is  to  stimulate  the  circulation  in  the  tooth- 
pulp,  the  alveolar  periosteum  (and  hence  also 
in  the  cementum  and  alveolar  walls  which  are 
supplied  by  it),  and  the  circumjacent  mucous 
membrane  of  the  gum.  All  this  makes  for  the 
health  of  the  teeth;  not  only  does  it  promote 
the  nutrition  of  the  tooth  itself  and  of  its  bony 
socket,  thus  maintaining  a  firm  dental  setting, 

[III] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

but  it  also  tends  to  secure  a  healthy  environ- 
ment for  the  exposed  part  of  the  tooth  —  that 
part,  namely,  wherein  caries  begins  —  by  main- 
taining a  healthy  state  of  the  surrounding  and, 
indeed,  of  the  entire  buccal  mucous  membrane, 
as  well  as  of  the  various  secretions  which  bathe 
the  mouth.  Wherefore  it  is  not  surprising  to 
find  that  those  who  masticate  efficiently  suffer 
much  less  from  dental  caries  and  its  complica- 
tions (such  as  abscess  at  the  root)  and  disease 
of  the  periodontal  membrane  (e.g..,  pyorrhoea 
alveolaris  and  loosening  of  the  teeth)  than  those 
who  are  accustomed  to  bolt  their  food. 

A  few  words  as  to  the  influence  of  mastica- 
tion in  wearing  down  the  teeth.  In  those  races 
which  masticate  vigorously  the  teeth  in  quite 
early  adult  life  show  signs  of  wearing  away, 
while  in  later  life  it  is  quite  common  for  the 
biting  surfaces  to  be  worn  flat;  sometimes  the 
crown  of  the  molars  is  worn  away  so  that  its 
surface  shelves  downwards  and  inwards  and  not 
infrequently  it  is  concave,  having  a  scooped-out 
appearance ;  often  the  dentine  is  exposed  in 
this  way;  and  yet  among  many  hundreds  of 
skulls  examined  I  do  not  remember  to  have 
seen  one  single  case  where  caries  has  started 
on  the  biting  surface  thus  worn  down. 

I  had  always  attributed  this  wearing  down  of 
the  teeth  to  the  friction  of  coarse  food  against 

[.12] 


The  A^B.'Z.  of  Our  Own  Nutrition 

them.  Primitive  races  eat  coarse  vegetable  food, 
which  frequently  contains  grit,  and  this  doubt- 
less helps  to  grind  the  teeth  down,  but  they 
may  be  markedly  ground  down  even  in  those 
living  on  soft  food,  and  in  such  cases  the  grind- 
ing away  can  obviously  only  be  due  to  the  fric- 
tion of  opposing  teeth  against  one  another.  I, 
indeed,  believe  this  to  be  the  essential  cause  of 
the  phenomenon,  both  in  civilised  races  living 
on  soft  food  and  in  primitive  races  whose  coarse 
food  necessitates  prolonged  and  vigorous  masti- 
cation and  a  corresponding  amount  of  attrition 
between  the  biting  surfaces  of  opposing  teeth. 
In  order  that  this  attrition  may  occur  two  things 
are  requisite :  the  upper  and  lower  teeth  must 
be  well  opposed  —  there  must  be  a  good  bite  — 
and  mastication  must  be  vigorous  and  of  the 
right  kind.  Mere  vertical  pressure  of  the  teeth 
against  one  another  will  not  wear  away  the  op- 
posing surfaces ;  there  must  be  friction  of  these 
surfaces  against  one  another  —  a  transverse  and 
sagittal  movement  of  the  lower  teeth  against  the 
upper  by  means  of  the  pterygoids.  Mainly  to 
this  do  I  attribute  the  marked  wearing  down  of 
the  teeth  observed  in  primitive  peoples,  and  I 
am  gratified  to  know  that  so  competent  an 
authority  on  dental  patholog}'-  as  Sim  Wallace 
is  a  convert  to  this  view. 

That  all  the  teeth  may  be  worn  down  just  as 
«  ["3] 


The  A,B,-Z,  of  Our  Own  Nutrition 

we  observe  in  primitive  people,  even  in  those 
who  have  Hved  all  their  hves  on  the  ordinary 
fare  of  the  moderns,  is  proved  by  a  case  I  have 
under  observation.  It  is  that  of  a  man  in  his 
fiftieth  year,  who  was  brought  up  in  Belgium 
but  who  has  resided  in  London  for  the  last 
thirty  years.  When  he  came  to  my  out-patient 
room  I  was  not  a  little  surprised  to  find  that  all 
his  teeth  were  sound  —  a  very  unusual  occur- 
rence, I  need  hardly  say,  among  the  London 
poor  at  his  age.  In  seeking  for  an  explanation 
I  elicited  the  fact  that  he  was  unable  to  swallow 
his  food  without  chewing  it  very  thoroughly, 
and  on  giving  him  a  moderate-sized  piece  of 
bread,  with  the  request  that  he  should  chew  it 
in  the  ordinary  way,  I  found  that  he  subjected 
it  to  one  hundred  and  twenty  separate  bites  be- 
fore swallowing  it,  and  in  the  steady,  deliberate 
way  he  went  to  work  and  in  his  extensive  lateral 
movements  of  the  mandible  he  reminded  one 
for  all  the  world  of  a  cow  chewing  its  cud.  The 
temporals  and  masseters  of  this  man  are  enor- 
mous, and  the  like  is  no  doubt  true  of  the  ptery- 
goids ;  he  has  well-developed  nasal  passages,  has 
never  suffered  from  nasal  obstruction,  while  his 
buccal  mucous  membrane  is  unusually  healthy 
for  one  of  his  years  and  circumstances.  May 
we  not  attribute  this  healthy  state  of  the  mouth, 
teeth,  and  nose  to  the  good  effects  upon  them 
["4] 


The  A,B,-Z,  of  Our  Own  Nutrition 

of  efficient  chewing?  Here  is  a  man  who  has 
lived  for  thirty  years  in  London  on  the  same 
kind  of  food  as  the  average  poor  Londoner,  but 
instead  of  finding  his  mouth  full  of  carious,  tar- 
tar-coated teeth,  and  spongy,  receding,  pus- 
exuding  gums,  we  find  thirty-two  sound  teeth 
firmly  set  in  healthy  gums  and  all  but  devoid 
of  tartar. 

A  word  as  to  the  wearing  down  of  the  teeth 
in  the  anthropoid  apes.  In  this  respect  the 
gorilla  differs  markedly  from  the  orang  and  the 
chimpanzee.  In  all  the  skulls  of  these  latter 
which  I  have  examined  the  teeth  show  signs  of 
wearing  away,  while  I  have  found  the  teeth  of 
the  gorilla,  with  the  exception  of  the  tusk-like 
canines,  but  little  worn.  From  this  we  should 
expect  the  latter  animal  to  be  mainly  carnivo- 
rous, and  the  orang  and  chimpanzee  to  be  largely 
herbivorous. 


Section  II.     From  London  Lancet,  July  i8,  1903 

Changes  which  the  Jaws  and  Teeth  of 
Man  have  undergone  during  Man's 
Evolution  from  his  Anthro- 
poid Ancestors 

During  man's  progress   upwards    from    the 
anthropoid  his  diet  has  undergone  a  progressive 
change,  and  a  parallel  adaptation  has  taken  place 
["S] 


The  A,B.-  Z,  of  Our  Own  Nutrition 

in  his  jaws  and  teeth.  Dietetically  considered, 
we  may  divide  his  evolutionary  career  into  the 
following  epochs^:  (i)  the  anthropoid  stage: 
(2)  the  pre-cooking  human  stage;  (3)  the  cook- 
ing pre-agricultural  stage;  (4)  the  early  agri- 
cultural stage;  and  (5)  the  late  agricultural 
stage. 

I .  The  anthropoid  stage,  —  The  diet  of  man's 
anthropoid  ancestors  was  probably  much  the 
same  as  is  that  of  existing  anthropoid  apes ;  it 
consisted,  namely,  of  raw  vegetable  and  animal 
food,  necessitating  a  vigorous  use  of  the  max- 
illary apparatus.  This  latter,  we  may  assume, 
was  of  the  type  belonging  to  the  anthropoids  — 
/.  ^.,  the  jaws  were  massive  and  markedly  prog- 
nathic ;  the  denture  was  the  same  as  it  is  in  ex- 
isting man,  but  the  teeth  were  larger,  especially 
the  upper  canines,  which  served  as  weapons  of 
offence  and  defence;  the  third  molars  (the  wis- 
dom teeth)  were  as  large  as  the  other  molars 
and  were  provided  with  three  fangs,  and  there 
was  an  ample  portion  of  alveolar  ridge  behind 
them ;  there  was  no  chin.  No  doubt  the  mas- 
siveness  and  the  marked  prognathism,  which 
characterised  the  jaws  at  this  stage,  served  other 
ends  than  that  of  mastication ;  it  is  obvious  that 
projecting  jaws  and  teeth  are  much  more  effec- 

1  This  subject  I  am  obliged  to  deal  with  very  briefly,  and 
am  compelled  to  omit  the  reasons  for  my  conclusions. 

[116] 


'The  A.B,-Z.  of  Our  Own  Nutrition 

tual  for  seizing  and  lacerating  prey  than  are  the 
orthognathic  jaws  of  modern  man. 

2.  Tke  pre-cooking  human  stage  extends  from 
the  time  man's  ancestors  first  assumed  the  hu- 
man form  till  they  learned  to  apply  fire  in  the 
preparation  of  their  food.  During  all  this  period 
the  jaws  and  teeth  were  probably  used  as  much, 
or  almost  as  much,  for  mastication  as  during  the 
anthropoid  stage ;  raw  animal  food  had  to  be  torn 
from  the  bones,  the  latter  had  to  be  crunched, 
while  the  bulk  of  the  raw  vegetable  food  needed 
then  no  less  than  it  needs  now  prolonged  and 
vigorous  mastication  in  order  to  liberate  the 
starch  and  other  nutritive  ingredients  from  their 
undigestible  cellulose  envelopes.^  Nevertheless, 
the  jaws  and  teeth  underwent  considerable 
change  during  this  period,  for  not  only  were 
they  with  every  advance  in  intelligence  called 
less  and  less  into  requisition  for  purposes  of 
offence  and  defence,  but  the  jaws,  at  least, 
became  materially  modified  in  correlation  with 
the  expanding  cranial  cavity  and  in  connection 
with  the  assumption  of  the  erect  posture.  It  is, 
I  think,  rather  for  these  reasons  than  in  conse- 
quence of  alterations  in  the  nature  of  the  food 
that  the    masticatory  apparatus  now  gradually 

1  Recent  observations  go  to  show  that  man  possesses  no 
power  of  digesting  cellulose,  though  this  substance  is  to  a 
limited  extent  capable  of  solution  by  the  agency  of  bacteria 
in  the  lower  portions  of  his  alimentary  canal. 

[.17] 


The  A.B.-Z,  of  Our  Own  Nutrition 

lost  its  more  bestial  aspect  and  assumed  an 
essentially  human  type,  becoming  towards  the 
close  of  the  period  much  the  same  as  may 
be  observed  among  the  most  primitive  peoples 
now  living. 

3 .  The  pre-agricultural  cooking  period.  —  The 
characters  of  the  maxillary  apparatus  belonging 
to  this  period  are  still  available  for  study,  the 
aboriginal  Australians,  the  Bushmen,  Negritos, 
and  many  Esquimaux  not  having  yet  emerged 
from  it.  So  far  as  mastication  is  concerned, 
cooking  influences  vegetable  far  more  than 
animal  food,  for  it  not  only  softens  it  but  by 
rupturing  the  undigestible  cellulose  chambers 
and  liberating  their  contents  relieves  mastication 
of  one  of  its  essential  functions.  Wherefore, 
with  the  advent  of  cooking,  man's  jaws  and  teeth 
began  to  get  smaller,  and  they  have  continued 
to  diminish  in  size  up  to  the  present  time.  No 
great  diminution,  however,  took  place  at  first, 
inasmuch  as  the  diet  still  continued  to  be  largely 
animal  (and  prior  to  the  use  of  knives  and  forks 
such  food  had  to  be  torn  by  the  teeth),  while 
the  coarse  vegetable  food  of  this  date,  even 
when  cooked,  still  needed  laborious  mastication. 
The  chief  differences  between  the  maxillary  ap- 
paratus of  this  early  cooking  age  as  compared 
with  that  of  the  present  day  are  as  follows :  the 
jaws  of  the  earlier  period  —  e.  g.,  in  the  abo- 
[ii8] 


The  A,  B.-Z.of  Our  Own  Nutrition 

riginal  Australian  —  are  more  massive,  and  their 
sagittal  diameter  is  greater,  giving  rise  to  de- 
cided prognathism,  the  teeth  for  the  most  part 
are  larger  and  stronger,  the  third  molars  being 
nearly,  if  not  quite,  as  big  as  the  other  molars, 
and  provided  with  three  fangs,  while  there  is 
a  considerable  portion  of  alveolar  ridge  behind 
them.  The  third  molars,  however,  show  a  de- 
cided tendency  to  be  smaller  than  the  rest,  and 
the  alveolar  ridge  behind  them  is  less  marked 
than  in  the  previous  period,  features,  I  doubt 
not,  attributable  to  the  influence  of  cooking  in 
diminishing  mastication.  Dental  caries  is  rare 
and  is  chiefly  met  with  in  the  third  molars. 

4.  The  early  agricultural  age,  —  All  the  exist- 
ing primitive  races  which  have  attained  to  the 
cultivation  of  the  soil  may  be  regarded  as  be- 
longing to  this  period.  Previously  to  it  man 
was  mainly  carnivorous,  owing  to  the  compar- 
atively limited  quantity  of  vegetable  food  avail- 
able, so  long  as  the  supply  waf  left  to  nature 
alone ;  but  when  by  cultivation  this  supply  was 
increased  and,  at  the  same  time,  rendered  more 
constant  and  certain,  he  gradually  became  less 
carnivorous  and  more  vegetarian  in  his  diet. 
The  result  of  agriculture,  however,  is  not  only 
to  increase  the  supply  of  vegetable  food,  but  to 
diminish  its  fibrous,  cellulosic  ingredients,  and 
thus  to  render  it  more  easily  masticated.  Hence 
["9] 


The  A.B.'Z,  of  Our  Own  Nutrition 

at  this  stage  we  find  the  maxillary  apparatus 
becoming  smaller  than  in  the  previous  period, 
although  the  difference  as  shown  —  e.g.y  by  the 
examinations  of  the  skulls  of  the  African  negroes 
and  the  Melanesians  —  is  less  pronounced  than 
we  might  perhaps  have  anticipated  ;  prognathism 
is  not  so  decided,  the  jaws  are  smaller,  also  the 
teeth,  especially  the  third  molars,  which  now 
for  the  first  time  show  a  tendency  to  be  fur- 
nished with  two  instead  of  three  fangs,  while 
the  alveolar  ridge  behind  them  is  distinctly 
shorter  than  in  the  preceding  period.  Dental  ca- 
ries, hitherto  rare,  now  becomes  more  frequent. 
5 .  The  late  agrictdtural period.  —  A  mid-agri- 
cultural period  might  be  described,  but  I  shall 
take  no  account  of  it  here,  but  pass  on  to  a  con- 
sideration of  the  late  agricultural  period  —  that, 
namely,  in  which  we  ourselves  live.  The  chief 
characteristic  of  the  food  of  this  period  is  its 
softness.  Cooked  animal  food  requires,  indeed, 
more  mastication  than  raw,  but  the  vegetable 
food  of  to-day,  owing  to  the  combined  effects  of 
improved  agriculture,  and  skilful  milling  and 
cooking,  is  so  soft  as  to  excite  comparatively 
little  mastication.  The  present  may,  in  fact,  be 
described  as  the  age  of  pap.  Hence  the  jaws 
and  teeth  are  now  called  upon  to  perform  far 
less  work  than  in  any  earlier  stage  of  our  evo- 
lution, and  there  has  taken  place  in  consequence 
[  120] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

a  great  diminution  in  their  size,  more  especially 
in  the  size  of  the  jaws,  so  that  there  is  now  often 
no  room  for  the  teeth  to  take  up  their  normal 
positions,  and  there  is  generally  a  complete  ab- 
sence of  alveolar  ridge  behind  the  last  molars. 
The  latter  are,  moreover,  apt  to  be  very  small 
or  even  absent,  while  dental  caries  is  alarmingly 
frequent. 

It  will  thus  be  seen  that  from  the  period  of 
the  anthropoids  to  the  present  time,  a  progres- 
sive change  in  the  size  and  shape  of  the  jaws  and 
teeth  has  been  taking  place,  a  change  which  is 
to  be  explained  by  (i)  the  cessation  of  the  need 
for  using  them  for  offensive  and  defensive  pur- 
poses ;  (2)  the  growing  capacity  of  the  cranium 
and  the  assumption  of  the  erect  position;  (3) 
the  progressive  alteration  in  man's  diet;  and 
probably  also  (4)  considerations  of  beauty. 
The  first  three  factors  have  operated  through 
natural  selection,  the  last  through  sexual  selec- 
tion, which  has  come  into  play,  I  would  sug- 
gest, chiefly  within  recent  times.  Probably  the 
most  pronounced  change  which  has  taken  place 
in  the  jaws  during  the  agricultural  periods  has 
been  the  suppression  of  prognathism  which,  in 
the  woman  especially,  is  very  unsightly,  and 
tends  to  diminish  the  likelihood  of  marriage. 


['"] 


T^he  A.B.-  Z.  of  Our  Own  Nutrition 

Instances  of  the  Vigorous  Use  to  which 

THE  Jaws  and  Teeth  are  put  among 

Existing  Primitive  Peoples 

A  study  of  existing  primitive  peoples  brings 
forcibly  home  to  the  mind  how  laboriously  the 
jaws  and  teeth  of  our  primitive  ancestors  were 
used.  I  have  already  shown  how  in  pre-agri- 
cultural  and  early  agricultural  times  the  nature 
of  the  food  compelled  a  sustained  and  vigorous 
exercise  of  these  structures,  and  I  wish  here 
only  to  refer  to  a  few  specific  and  peculiar  in- 
stances of  laborious  mastication  exercised  by 
primitive  races  now  or  recently  living.^  Among 
some  of  these  mastication  has  been  promoted 
almost  to  the  position  of  an  industrial  art. 

The  chewing  of  very  tough  substances  in  order 
to  extract  therefrom  liquid  or  nourishment.  —  The 
recently  extinct  Tasmanians  included  among 
their  articles  of  diet  a  species  of  sea-weed  which, 
even  when  cooked,  was  so  tough  as  to  require 
long-sustained  mastication  in  order  to  extract 
its  nutrient  elements.  The  Indians  of  North 
California  chew  kelp,  which  is  **as  tough  as 
white  leather  "  (/.  e.,  leather  dressed  with  alum). 
"  A  young  fellow  with  good  teeth  will  masticate 

1  I  am  under  great  obligation  to  Miss  Eva  Dunn,  who  has 
collected  valuable  information  for  me  on  this  and  kindred 
subjects. 

[122] 


The  A.B.-  Z,  of  Our  Own  Nutrition 

a  piece  of  it  a  whole  day."  Again  Featherman  ^ 
tells  how  when  the  Bushmen  are  short  of  food 
in  the  winter  they  steep  an  old  dried  gnu-skin  in 
water  and,  having  rubbed  off  the  hair,  boil  it, 
and  proceed  to  gnaw  the  tough  morsel  until 
their  very  jaws  ache.  The  Modoc  Indians  are 
said  to  munch  the  raw  kais  root  all  day  long.^ 
Among  the  Esquimaux  it  is  a  universal  custom 
to  chew  the  raw  skin  of  the  whale,  the  porpoise, 
and  the  seal  for  the  blubber  it  contains,  and  the 
skin  being  as  tough  as  india-rubber,  it  requires, 
as  may  be  imagined,  a  good  deal  of  chewing. 
The  Lower  Californians  also  chew  deer-skin  and 
ox-skin  (Bayert).  The  more  southern  Esqui- 
maux, according  to  Nansen,  preserve  the  stalks  of 
angelica  by  steeping  them  in  a  mixture  of  chewed 
blubber  and  saliva.  Finally,  I  may  refer  to  the 
habit  of  chewing  the  sugar-cane,  a  practice 
which  is  prevalent  among  the  natives  in  all 
countries  where  the  cane  grows,  and  affords,  it 
need  scarcely  be  said,  abundant  exercise  for 
the  jaws  and  teeth. 

Mastication  in  the  preparation  of  beverages.  — 
I  find  that  among  widely  separated  aboriginal 
peoples  chewing  is  resorted  to  in  the  preparation 
of  beverages,  both  intoxicating  and  non-intoxi- 
cating.    The  Gran  Chaco  Indians  make  an  in- 

1  Social  History  of  the  Races  of  Mankind,  1881. 

2  S.  Powers  :  Tribes  of  California,  1877. 

[  ^23] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

toxicating  drink  by  chewing  the  algarroba  bean 
and  then  spitting  into  a  receptacle.  In  other 
parts  of  South  America  berries  are  chewed  with 
the  same  object.  In  some  of  the  Pacific  Islands 
boys  and  girls  with  good  teeth  are  selected  to 
chew  a  root  (kava),  from  which  they  then  pre- 
pare a  drink.  In  New  Guinea  drinks  are  sim- 
ilarly prepared  from  roots.  Boiled  cassava  root 
is  chewed  by  the  Indians  of  Nicaragua  for  the 
same  purpose.  In  British  Guiana  the  natives 
make  a  drink  by  adding  chewed  maize  and 
saliva  to  sweet  potato,  maize,  and  sugar-cane. 
The  Indians  in  Honduras,  after  steeping  cassava 
cake  or  carbonised  bread  in  hot  water,  chew  a 
portion  and  mix  it  with  the  rest. 

Mastication  in  the  industries.  —  Even  among 
moderns  teeth  are  used  for  many  purposes 
other  than  mastication  —  e.  g.y  for  holding  pins 
and  needles  and  for  severing  cotton  ;  also  in  some 
industries  —  e.  g,,  among  diamond  workers  — 
where  it  is  the  custom  for  girls  to  hold  the 
diamond  between  their  front  teeth,  which  in 
consequence  get  much  worn  away,  as  I  have 
myself  seen.  It  is  only  among  primitive  peoples, 
however,  that  the  jaws  and  teeth  actually  play 
the  part  of  implements  for  use  in  the  arts.  The 
Australian  women  make  lines,  nets,  and  bags 
by  chewing  various  kinds  of  fibre,  a  process 
which  wears  down  their  teeth  considerably  and 
["4] 


T^he  A.B.-Z.  of  Our  Own  Nutrition 

may  cause  them  to  be  tender.^  The  Esqui- 
maux are  still  more  dependent  upon  the  use  of 
their  teeth  as  implements,  especially  in  the 
preparation  of  skins  for  their  clothing,  boats, 
and  lines.  The  teeth  are  used  to  hold  the  skins, 
while  the  latter  are  being  scraped,  the  mouth 
constituting,  in  fact,  "  a  third  hand ;  "  and  the 
front  teeth  of  Esquimaux  women  are  often  by 
this  means  worn  away  to  the  merest  stumps.^ 
The  garments  of  the  Esquimaux,  even  to  the 
boots,  are  made  up  of  skins  which  have  been 
laboriously  chewed  for  this  purpose  by  the 
women  "  inch  by  inch,"  till  they  acquire  a  beau- 
tiful softness  and  flexibility,  and  are  often,  in- 
deed, chewed  again  after  having  been  dried. 
And  we  are  told  that  the  women  have  no  objec- 
tion to  the  task,  while  the  children  are  eager  to 
help  in  it  on  account  of  the  blubber  the  skin 
contains ;  also,  that  in  bad  times  the  men  do  not 
object  to  join  in  the  work.  The  lines  for  har- 
pooning are  prepared  in  a  similar  way  from 
the  skin  of  the  bearded  seal,  and  in  very  large 
quantities.^  When  we  think  of  the  quantity  of 
skins  needed  for  these  lines,  for  their  dress, 
including  boots  and  gloves,  and  for  their  boats 

1  E.  M.  Curr  :  The  Australian  Races,  1886-7.  Taplin :  The 
Narrinyeri ;  an  account  of  Tribes  of  South  Australian  Abo- 
rigines, 1879. 

2  J.  F.  Nansen :  Eskimo  Life,  1893. 

*  Dr.  Kane :  Arctic  Exploration,  1854. 


The  A.B.-Z,  of  Our  Own  Nutrition 

(although  for  the  latter  some  skins  are  used 
without  having  first  undergone  chewing),  it  is 
clear  that  enormous  quantities  must  be  chewed. 
The  Esquimaux  men  also  use  their  teeth  con- 
siderably in  other  work  —  e.  g.j  in  lashing  the 
sledges  together.^  The  Indians  of  North  Cal- 
ifornia use  their  teeth  for  stripping  the  bark 
from  the  fresh  shoots  employed  in  making  their 
wickerwork  utensils,  and  they  also  employ  their 
teeth  in  making  strings,  cords,  and  nets. 

The  Instinct  to  Masticate 
Seeing  that  the  maxillary  apparatus  of  man 
has  for  long  ages  past  been  put  to  vigorous  use, 
it  is  not  surprising  that  the  need  to  exercise  it 
should  express  itself  as  a  powerful  instinct. 
This  instinct  manifests  itself  in  many  and  curious 
ways,  some  of  which  I  will  now  consider.  Dur- 
ing the  early  months  of  life  the  natural  function 
of  feeding  at  the  breast  provides  the  infant's 
jaws,  tongue,  and  lips  with  all  the  needful  exer- 
cise. This  bottle-feeding  fails  to  do,  and  we 
frequently  find  bottle-fed  children  seeking  to 
satisfy  the  natural  instinct  by  sucking  their 
thumb,  fingers,  or  any  convenient  object  to 
hand.  The  teeth  are  a  provision  for  biting  hard 
foods,  but  even  before  they  actually  appear  we 
find  the  child  seeking  to  exercise  his  toothless 

1  E.  Astrup  :  With  Peary  near  the  Pole,  1898. 
[,26] 


The  A.B.-Z,  of  Our  Own  Nutrition 

gums  on  any  hard  substance  he  can  lay  hold  of, 
and  there  can  be  no  doubt  that  exercise  of  this 
kind  tends  to  facilitate  the  eruption  of  the  teeth, 
a  truth,  indeed,  recognised  universally,  whether 
by  the  primitive  mother  who  strings  the  tooth 
of  some  wild  animal  round  the  neck  of  her  in- 
fant, or  the  up-to-date  parent  who  provides  her 
child  with  a  bejewelled  ivory  or  coral  bauble. 
When  the  teeth  have  erupted,  the  masticatory 
instinct  finds  among  primitive  peoples  abundant 
satisfaction  in  the  chewing  of  the  coarse,  hard 
foods  which  constitute  their  dietary ;  but  among 
us  moderns,  subsisting  as  we  do  mainly  on  soft 
foods,  affording  but  little  exercise  for  the  mas- 
ticatory apparatus,  it  does  not  find  its  proper 
expression,  and  thus  tends  to  die  out.  Never- 
theless, it  dies  a  hard  death,  and  long  continues 
to  assert  itself;  witness  the  tendency  of  chil- 
dren to  bite  their  pencils  and  pen-holders ;  I 
have  known  a  child  to  gnaw  through  a  bone 
pen-holder,  much  in  the  same  way  as  a  carniv- 
orous animal  gnaws  at  a  bone. 

This  instinct  to  chew  for  chewing's  sake  man- 
ifests itself  all  over  the  world.  In  our  own 
country  not  only  do  children  bite  pencils  and 
pen-holders,  but  they  will  chew  small  pieces  of 
india-rubber  for  hours  together.  The  practice 
of  gum-chewing,  so  common  among  our  Amer- 
ican cousins,  evidently  comes  down  from  far-off 
L  127] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

times,  for  the  primitive  Australians  chew  several 
kinds  of  gum,  attributing  to  them  nutrient  qual- 
ities,^ and  the  Patagonians  are  said  to  keep 
their  teeth  white  and  clean  by  chewing  matrix  a 
gum  which  exudes  from  the  incense  bush,  and 
is  carefully  collected  by  the  women  and  chil- 
dren.^ 

A  widespread  custom  in  the  East  is  betel- 
chewing,  which  is  met  with  in  India,  Malay, 
Melanesia,  and  Polynesia,  and  even  among  the 
primitive  Veddahs  of  Ceylon.  This  article  is 
composed  of  the  pungent  leaf  of  the  betel  plant, 
the  areca  nut  and  lime  rolled  together,  and 
when  chewed  yields  a  reddish  juice  which  stains 
the  mouth  and  teeth.  The  Veddahs,  failing 
to  get  the  genuine  article,  manufacture  a  quid 
from  the  leaves  of  an  aromatic  plant,  the  barks 
of  one  or  two  kinds  of  tree,  and  calcined  small 
shells.^  The  compound  must  possess  some 
strange  attraction,  for  otherwise  such  pains  would 
not  be  taken  to  secure  it.  What  is  the  attrac- 
tion? Doubtless  betel  has  stimulating  proper- 
ties, and  it  must,  moreover,  be  remembered 
that  the  mere  mechanical  act  of  mastication 
stimulates  the  circulation,  a  fact  which  helps  to 

1  Sir  George  Grey  :  Journal  of  Two  Expeditions  in  North- 
West  and  Western  Australia,  1841. 

*  Muster:  With  the  Patagonians,  1869. 

•  Bailey:  Transactions  of  the  Ethnological  Society,  1862. 

[.28] 


T^he  A,B.-  Z,  of  Our  Own  Nutrition 

explain  the  tendency  for  man,  all  the  world  over, 
to  chew  non-nutrient  substances.  Tobacco- 
chewing  is  common  in  many  parts  of  the  world, 
and  here,  again,  the  effect  for  the  time  is  stimu- 
lating. Pitcherie  is  extensively  chewed  among 
the  aboriginal  Australians ;  it  consists  of  twigs 
of  about  the  thickness  of  rye-grass  stems,  which 
are  first  chewed  into  a  mass,  then  mixed  with 
the  ash  of  gum  trees,  and  made  into  a  paste, 
which  is  chewed  for  its  stimulating  and  narcotic 
effects.^ 

I  may  allude  in  passing  to  the  grinding  of  the 
teeth,  which  takes  place  during  sleep  in  dis- 
turbed states  of  the  nervous  system.  It  is  a 
true  masticatory  act,  in  which  the  normal  lateral 
movement  of  the  mandible  is  well  marked,  and 
it  may  thus  be  regarded  as  a  perverted  mani- 
festation of  the  masticatory  instinct. 

The  Causation  of  Inefficient  Mastication 
The  effects  for  good  upon  the  organism  of 
efficient  mastication  being  profound  and  far- 
reaching,  it  follows  that  inefficient  mastication 
must  lead  to  many  evils.  What  these  are  we 
have  now  to  consider ;  but  first  it  will  be  well 
to  inquire  into  the  causes  of  the  defective  mas- 
tication which  prevails  among  moderns. 

I.  Softness  of  food.  —  By  far  the  most  impor- 

1  E.  M.  Curr:  The  Australian  Race,  1886-87. 
9  [  129  ] 


The  A,  B,-Z,of  Our  Own  Nutritton 

tant  of  these  lies  in  the  nature  of  the  food  taken. 
The  food  of  to-day  —  of  the  late  agricultural 
age  period,  as  I  have  termed  it  —  is  for  the 
most  part  soft  and  pappy,  of  a  kind  which  does 
not  compel  thorough  mastication ;  so  much  so, 
indeed,  that,  as  I  have  already  said,  we  may 
speak  of  this  as  the  age  of  pap.  This  feature  is 
especially  noticeable  in  the  case  of  children's 
diet:  under  the  modern  system  children  are  kept 
on  a  liquid,  or  semi-Hquid,  diet,  not  merely  dur- 
ing the  first  months,  but  during  the  first  years 
of  life,  and  at  the  seventh  or  eighth  month  all 
kinds  of  artificial  saccharide  foods  in  liquid  or 
semi-liquid  form  are  poured  into  the  child's 
stomach ;  thereafter  he  is  fed  on  such  viands  as 
mashed  potatoes  and  gravy,  rusks  soaked  in 
milk,  milk  puddings,  bread  dipped  in  bacon  fat, 
pounded  mutton,  thin  bread-and-butter,  and  the 
like;  and  we  are  told  that  this  is  the  kind  of 
diet  best  suited  to  the  young  human,  from  the 
time  of  weaning  to  the  end  of  the  second  year ! 
The  same  pernicious  methods  are  adopted  sub- 
sequently. *'  Perhaps  the  great  majority  of  chil- 
dren after  they  have  got  their  complete  set  of 
temporary  teeth  have,"  writes  Dr.  Sim  Wal- 
lace,^ "  a  dietary  such  as  the  following.  Break- 
fast:   bread-and-milk   or   porridge,    milk,    tea, 

1  The  Causes  and  Prevention  of  Decay  in  Teeth,  pp.  88, 
89.     London,  1902. 

['30] 


The  A.B,-Z.  of  Our  Own  Nutrition 

coffee,  or  cocoa,  bread-and-butter,  perhaps  an 
egg.  Dinner:  potatoes  and  gravy,  or  meat, 
milk  pudding.  Tea:  milk  or  tea  with  bread- 
and-butter,  jam,  cakes.  Supper :  bread  or  bis- 
cuit and  milk."  Now  food  of  this  kind  does  not 
invite  mastication,  and  it  finds  its  way  into  the 
stomach  all  too  readily.  Hence  the  instinct  to 
masticate  has  little  opportunity  of  exercise  and, 
not  being  properly  exercised,  tends,  as  I  have 
said,  to  die  out.  Small  wonder  that  the  child 
nourished  on  such  pappy  food  acquires  the  habit 
of  bolting  it,  and  learns  to  reject  hard,  coarse 
foods  in  favour  of  the  softer  kinds ;  everything 
nowadays  must  be  tender,  pultaceous,  or  **  short." 
Given  a  choice  between  a  food  compelling  little  or 
no  mastication  and  one  necessitating  prolonged 
mastication  —  as  between,  say,  fresh  Vienna 
bread  and  an  Abernethy  biscuit  —  and  in  nine- 
teen cases  out  of  twenty  the  one  which  gives 
the  least  trouble  in  eating  will  be  chosen.  To 
such  absurd  lengths  has  this  harmful  custom 
been  pushed  that  even  bread  crust  is  avoided 
by  many.  Witness  the  fashion  of  eating  bread- 
and-butter  with  a  minimum  of  crust;  order 
bread-and-butter  at  any  place  of  refreshment, 
and  the  last  thing  you  will  be  served  with  is  a 
plateful  of  crusts  of  bread.  Many  establish- 
ments, indeed,  make  a  regular  practice  of  giv- 
ing away  their  crusts  as  unsaleable.     Thus,  the 


The  A.B.'Z,  of  Our  Own  Nutrition 

rectangular  loaves  used  for  bread-and-butter  in 
the  '*  Aerated  bread-shops  "  are  cut  transversely 
into  slices,  each  loaf  thus  yielding  two  end 
crusts  v^^hich  are  put  into  baskets  for  the  poor, 
only  the  soft  crumby  pieces  being  reserved  for 
the  customers,  to  be,  in  due  course,  no  doubt 
washed  down  by  copious  libations  of  tea  and 
coffee. 

When  we  trace  the  diet  of  the  modern  from 
childhood  upwards  we  find  the  same  story: 
it  tends  to  remain  soft  and  pappy  to  the  end. 
Animal  food,  especially  as  it  comes  to  the  tables 
of  the  well-to-do,  necessitates  very  little  mas- 
tication. It  is  the  coarser  varieties  of  vegetable 
food  alone  which  call  out  the  full  functional  ac- 
tivity of  the  masticatory  apparatus,  but  the  veg- 
etable food  of  to-day  is  rarely  of  a  kind  to  do 
this;  cooked  vegetables,  such  as  potatoes, 
greens,  peas,  and  beans,  can  be,  and  generally 
are,  swallowed  after  little  or  no  preliminary 
mastication,  and  our  flour  is  so  carefully  de- 
prived of  its  fibrous  portions  and  so  cunningly 
dealt  with  in  the  bakehouse  and  kitchen  in  the 
making  of  bread,  cakes,  and  pastry  which  shall 
eat  light  and  short  that  these  articles  get  very 
little  chewing;  while  such  vegetable  products 
as  rice,  vermicelli,  tapioca,  and  macaroni  are,  as 
served  at  table,  so  soft  that  they  slip  down  into 
the  stomach  almost  as  readily  as  simple  milk. 
[  ^32] 


The  A,B,-Z.  of  Our  Own  Nutrition 

Let  any  one  run  through  his  dietary  of  any  one 
day,  and  he  will  realise  how  very  little  work  his 
masticatory  apparatus  is  called  upon  to  perform. 
It  will  read  something  Hke  the  following. 
Breakfast:  porridge  and  milk,  eggs,  bacon, 
bread,  and  marmalade.  Lunch:  fish,  tender 
meat,  boiled  vegetables,  bread,  some  "  sweet," 
and  cheese.  Tea:  bread,  butter,  and  cake. 
Dinner:  much  the  same  as  lunch.  What  op- 
portunity, I  ask,  does  such  a  bill-of-fare  afford 
for  the  development  of  teeth  and  jaws,  and  for 
the  proper  functional  activity  of  the  salivary 
glands  ? 

2.  Defective  masticatory  apparatus, — Another 
potent  cause  of  inefficient  mastication  is  some 
defect  in  the  masticatory  apparatus,  and  defects 
of  this  kind  are  very  common  in  those  who 
have  not  been  accustomed  to  masticate  thor- 
oughly in  early  life.  Foremost  among  these  are 
irregularities  of  the  teeth  leading  to  faulty 
"  bite "  and  caries  of  the  teeth  which  causes 
them  to  be  tender  or  to  break  away,  if  it  does 
not  lead  to  their  actual  extraction.  Mastication 
cannot  be  thorough  where  the  bite  is  defective, 
for  this  not  only  leads  to  imperfect  opposition 
of  the  upper  and  lower  teeth,  but  renders  the 
lower  ones  incapable  of  that  ample  lateral 
movement  against  the  upper  which  is  needful 
to  normal  mastication. 

[133] 


The  A,B.'  Z.  of  Our  Own  Nutrition 

3.  Idiosyncrasy.  —  Some  are  temperamentally 
more  disposed  to  hurry  over  their  meals  than 
others.  The  katabolic,  restless,  nervous  indi- 
vidual is  more  apt  to  swallow  his  food  hastily 
than  is  his  more  deliberate  and  phlegmatic 
brother.  Individual  differences  in  this  re- 
spect are  even  observed  among  the  lower  an- 
imals. Thus,  one  of  a  pair  of  horses  of  about 
the  same  age  and  build  is  nervous  and  excitable 
and  inclined  to  bolt  its  food,  while  its  companion 
of  more  stolid  temperament  is  a  thorough  and 
efficient  masticator.  The  former  shows  com- 
paratively little  wearing  down  of  the  teeth,  and 
often  suffers  from  indigestion,  a  large  portion  of 
corn  grains  passing  through  his  digestive  canal 
intact;  in  the  latter  the  teeth  are  well  worn, 
indigestion  never  occurs,  and  but  very  few 
grains  pass  through  the  digestive  tract  un- 
changed. It  may  be  objected  here  that  we  can- 
not help  temperament,  and  to  a  large  extent 
this  is  true;  but  much  can  be  done  towards 
modifying  it,  and  it  is  something  to  know  where 
dangers,  temperamental  dangers,  among  others, 
lie. 

4.  Circumstances  of  life,  —  Again,  in  this 
hurrying,  strenuous  age  people  are  much  less 
deliberate  than  in  the  easy,  slow-going  days  of 
long  ago.  A  meal  is  too  often  regarded  as 
something  to  be  got  through  quickly,  as  taking 

[•34] 


'The  A.B,-Z,  of  Our  Own  Nutrition 

up  time  which  might  be  devoted  to  something 
more  profitable.  Especially  is  this  true  of 
breakfast  and  lunch ;  it  is  no  uncommon  thing 
for  a  business  man  to  hurry  through  his  break- 
fast in  a  few  minutes,  preparatory  to  rushing  off 
to  his  train,  and  his  lunch  as  likely  as  not  is 
as  hastily  swallowed  in  his  office  or  at  a  bar. 
Tradesmen  are  apt  to  take  their  meals  in  mere 
snatches;  apprentices,  shop  girls,  and  other 
"  hands  "  are  often  not  allowed  sufficient  time 
for  their  meals;  while,  to  come  to  the  pro- 
fessions, we  all  know  how  the  busy  medical 
man,  for  instance,  is  often  obliged  to  take  a 
hurried  snack  in  the  short  intervals  between 
seeing  his  patients.  No  wonder  that  thus  cir- 
cumstanced people  acquire  the  habit  of  bolting 
their  food.  A  meal  should  be  regarded  as  an 
end,  and  an  important  end,  in  itself.  It  should 
be  taken  at  leisure,  body  and  mind  being,  for 
the  time  being,  given  up  to  it,  and  to  agreeable 
social  intercourse.  If  this  rule  were  always  ob- 
served a  most  important  source  of  inefficient 
mastication  would  be  removed. 

Section  III.     From  London  Lancet.,  July  25,  1903 

Evils  resulting  from  Inefficient 

Mastication 
Too  much  food  is  eaten.  —  Inefficient  masti- 
cation conduces  to  excessive  eating.     Now  it  is 

[135] 


'The  A,B,-Z.  of  Our  Own  Nutrition 

obvious  that  soft  foods,  and  these  constitute  the 
bulk  of  our  modern  dietary,  pass  much  more 
readily  into  the  stomach  than  coarse,  hard  foods 
which  compel  a  certain  amount  of  preliminary 
mastication,  and  for  this  reason  the  former  pre- 
dispose to  excessive  eating :  hence  a  danger  at 
all  periods  of  life,  not  only  in  grown-ups  but  in 
children,  even  infants ;  brought  up  as  the  latter 
are,  mainly  on  Hquid  and  pappy  foods,  many  of 
them  consume  not  only  far  more  than  is  needful, 
but  far  more  than  is  healthful,  their  stomachs 
being  literally  deluged  with  nutriment. 

When  the  food  is  of  a  kind  necessitating 
abundant  mastication  it  is  much  less  likely  to  be 
taken  in  excess,  for  the  longer  the  time  spent  in 
mastication  the  less  will  the  individual  be  tempted 
to  consume ;  even  in  the  case  of  soft  food,  less 
will  probably  be  eaten  if  it  be  thoroughly  mas- 
ticated and  insalivated  than  if  it  be  bolted. 
Thorough  mastication,  however,  not  only  tends 
to  diminish  the  amount  of  food  consumed  on 
account  of  the  time  and  labour  which  it  entails ; 
it  actually  reduces  the  amount  needful  to  con- 
stitute a  sufficiency,  for  the  more  perfectly  the 
food  is  chewed  the  more  perfectly  is  it  digested 
and  the  more  economically  is  it  disposed  of 
in  the  system;  the  less,  moreover,  is  the  ten- 
dency to  that  morbid  craving  for  food  which 
is  so  frequent   an  accompaniment  of  defective 

[136] 


l^he  A,B.-Z,  of  Our  Own  Nutrition 

digestion.  It  is  certain  that  appetite  and  the 
needs  of  the  system  are  sooner  satisfied  when 
food  is  well  masticated  and  digested  than  when 
it  is  swallowed  whole. 

A  mass  of  unmasticated  food  may  lodge  in  the 
throat  and  cause  fatal  suffocation.  —  This  may 
seem  to  be  a  very  exceptional  kind  of  evil,  but 
I  am  informed  by  one  whose  experience  make§ 
him  an  authority  on  the  ways  of  the  British 
soldier  that  it  is  by  no  means  uncommon  for 
soldiers  in  barracks  to  die  from  this  cause. 
Usually  it  is  when  they  are  under  the  influence 
of  alcohol  that  fatal  results  occur,  post-mortem 
examination  disclosing  large  undigested  masses 
of  food  in  the  stomach.  A  Hke  experience  is 
also  frequently  met  with  in  the  case  of  men 
killed  by  accident. 

The  presence  of  masses  of  imperfectly  masti- 
cated food  in  the  stomach  may  cause  disturbance 
either  mechanically  or  by  reason  of  their  impervi- 
ousness  to  the  gastric  juices.  —  We  have  already 
seen  that  the  digestibility  of  a  food  is  largely 
determined  by  its  consistence,  and  that  many 
articles  of  diet,  such  as  cheese,  hard-boiled  ^%g^ 
cocoa-nut,  lobster,  and  new  bread,  which  have 
the  reputation  of  being  very  indigestible,  can,  if 
finely  comminuted  by  chewing  or  otherwise,  be 
rendered  quite  digestible.  Such  articles  are  in- 
digestible essentially  by  reason  of  their  compact- 
['37] 


The  A,B,'Z.  of  Our  Own  Nutrition 

ness ;  the  compact  lumps,  but  little  pervious  to 
the  gastric  juice,  tend  to  undergo  abnormal  chemi- 
cal change  in  the  stomach,  and  may  in  this  way 
cause  violent  local  irritation,  even  to  the  extent  of 
setting  up  acute  gastritis ;  or  they  may  paralyse 
the  nerves  of  the  stomach  and  check  gastric 
secretion  and  movement,  and  thus  remain  in  loco 
wholly  undigested  for  hours  or  even  days ;  or, 
again,  more  distant  nervous  effects  may  be  pro- 
duced, such  as  frontal  headache,  which  may  be 
felt  almost  immediately  after  ingestion  of  the 
peccant  substance,  being  of  reflex  rather  than 
toxic  origin,  and  presumably  in  some  cases,  at 
least,  due  to  the  mere  mechanical  irritation  of 
the  stomach.  The  passage  of  imperfectly 
digested  food  into  the  bowel  may  still  further 
aggravate  matters.  It  does  not  seem  improb- 
able that  the  habitual  bolting  of  food,  by  the 
prolonged  local  irritation  to  which  it  gives  rise, 
may  predispose  to  cancer  of  the  stomach: 
Napoleon  was  a  notorious  fast  eater  and  it  is 
well  known  that  he  died  from  this  disease. 

While,  however,  the  bolting  of  food  readily 
sets  up  disturbance  in  some,  it  must  be  con- 
ceded that  in  many  it  seems  to  cause  little  or  no 
inconvenience ;  especially  is  this  the  case  in  the 
young  with  vigorous  muscular  stomachs  capable 
of  triturating  the  food,  and  thus  doing  duty  for 
the  teeth.      The  human  stomach  is,  indeed,  a 

[138] 


Tihe  A.B.-Z,  of  Our  Own  Nutrition 

long-suffering  organ,  and  wonderfully  tolerant  of 
ill-treatment,  sometimes  almost  rivalling  in  its 
hardiness  the  gizzard  of  the  bird.  Nor  is  this 
surprising  when  we  reflect  that  it  is,  in  the 
ordinary  course  of  nature,  constantly  exposed 
to  the  entrance  of  noxious  substances.  In  this 
respect  it  stands  in  marked  contrast  to  the 
intestines,  for  not  only  are  highly  irritant  sub- 
stances often  vomited  rather  than  passed  on- 
wards, but  in  ordinary  circumstances  the  gastric 
contents  are  not  allowed  to  pass  the  pylorus,  until 
they  have  been  duly  prepared  by  the  stomach ; 
the  pylorus,  in  fact,  stands  guard  over  the 
entrance  to  the  bowel  and  is  jealous  of  anything 
passing  it  which  is  likely  to  injure  that  canal. 

And  just  as  the  pylorus  protects  the  bowel  so, 
in  exceptional  cases,  may  the  oesophagus  protect 
the  stomach,  regurgitating,  after  the  fashion  of 
the  ruminants,  insufficiently  masticated  bits  of 
food,  in  order  that  they  may  be  re-masticated. 
I  have  myself  met  with  cases  in  point.  Some- 
times, in  cases  of  this  kind,  the  oesophagus 
may  be  dilated  into  a  sort  of  proventriculus, 
which  is  capable  of  temporarily  lodging  a  large 
quantity  of  food.  Such  a  proventriculus  is  said 
to  have  developed  in  an  apprentice  who,  not 
being  allowed  sufficient  time  for  his  dinner, 
rapidly  bolted  it,  to  regurgitate  it  after  working 
hours  and  to  chew  the  cud  at  leisure.  Whether 
[  139] 


The  A,B.'Z,  of  Our  Own  Nutrition 

in  these  cases  the  food  is  ever  returned  from 
the  stomach  itself  I  am  unable  to  say. 

While  the  stomach  is  the  organ  especially 
liable  to  be  injured  by  the  swallowing  of  lumps 
of  unmasticated  food,  the  bowel  may  also  suffer, 
especially  the  caecum  and  vermiform  appendix. 
And  here  we  come  to  one  of  the  most  serious 
indictments  against  the  bolting  of  food  ;  though 
man  has  doubtless  always  suffered  from  appen- 
dicitis, there  can  be  little  doubt  that  this  malady 
is  more  common  now  than  it  used  to  be;  and 
there  is  equally  little  doubt,  in  my  own  mind  at 
least,  that  the  cause  of  its  greater  frequency  is 
related  to  his  food.  I  do  not  propose  to  discuss 
here  in  detail  how  food  is  capable  of  causing 
appendicitis,  but  will  merely  refer  to  one  of  the 
ways  in  which  it  may  do  so.  I  had  already  come 
to  the  conclusion  that  the  habit  of  bolting  food 
is  a  potent  cause,  when  I  read  Sir  Frederick 
Treves's  Cavendish  Lecture  in  which  he  makes 
that  contention.  Sir  Frederick  Treves  points 
out  that  in  this  rushing  age  people,  especially 
business  men,  are  apt  to  hurry  over  their  meals 
and  to  take  them  at  irregular  times  and  often 
while  standing  at  a  bar;  even  when  there  is 
more  leisure,  food  is  rarely  masticated  nowadays 
in  the  same  thorough  way  that  it  was  in  the  old 
time,  when  it  was  of  a  coarser  nature :  hence 
sohd  lumps,  especially  in  the  case  of  such  articles 
[  140] 


7he  A,  B.-Z.of  Our  Own  Nutrition 

as  pine-apple,  preserved  ginger,  nuts,  tough 
meat,  and  lobster,  are  apt  to  pass  beyond  the 
pylorus  and,  escaping  intestinal  digestion,  to 
lodge  in  the  caecum  and  precipitate  an  attack 
of  appendicitis,  the  most  common  predisposing 
cause  of  which  is  a  loaded  caecum,  often  pre- 
ceded by  constipation.  Sir  Frederick  Treves 
contends  that  this  distended  state  of  the  caecum 
encourages  catarrh  of  the  appendix  by  dragging 
upon  it  and  blocking  its  orifice,  as  well  as  by 
twisting  it  and  thus  interfering  with  its  blood- 
supply.^ 

An  excess  of  starch  is  apt  to  pass  into  the 
stomach.  —  We  have  just  seen  that  inefficient 
mastication  tends  to  promote  over-eating,  and 
what  has  been  said  on  this  head  applies  to  all 
kinds  of  food,  starchy  foods  among  others.  It 
leads,  however,  to  a  further  evil  as  regards  these 
latter ;  not  only  does  it  tend  unduly  to  increase 
the  quantity  of  them  consumed,  but  it  too  often 
causes  the  stomach  and  intestines  to  become 
flooded  with  starch  in  a  wholly  undigested  form. 
I  cannot  too  frequently  repeat  that  in  ancient 
times,  especially  in  the  pre-cooking  age,  laborious 

1  Gilbert  Barling  also  traces  the  relationship  between  ap- 
pendicitis and  diet.  "  In  a  considerable  number  of  cases,"  he 
writes,  "  the  attack  of  appendicitis  can  be  directly  attributed 
to  unsuitable  food  —  pork,  mackerel,  over-ripe  or  under-ripe 
fruit,  uncooked  vegetables  "  (Brit.  Med.  Jour.,  vol.  i.,  1903, 
p.  6,). 

[  141  ] 


"The  A.B.-  Z.  of  Our  Own  Nutrition 

mastication  was  needed  in  the  case  of  all  starchy 
foods,  partly  because  they  were  coarse  and 
fibrous,  but  chiefly  because  the  starch  and  other 
nutritive  ingredients  had,  in  order  to  become 
available  for  nutrition,  to  be  liberated  from  their 
undigestible  cellulose  envelopes.  In  these  days 
of  prepared,  soft,  starchy  foods,  however,  masti- 
cation is  very  little  required  for  these  purposes, 
but  in  other  respects  it  is  as  needful  as  ever, 
indeed  more  needful,  if  the  large  quantities  of 
starch  which  are  now  consumed  are  to  be  insali- 
vated effectually.  The  laborious  and  sustained 
mastication  to  which  primitive  man  was  com- 
pelled to  subject  ^^'j  limited  supplies  of  uncooked 
starchy  food,  went  far  to  effect  complete  digestion 
of  the  starch  within  the  mouth,  for  raw  starch  is 
freely  digested  by  the  saliva,^  and  hence  in  his 
case  very  little  passed  into  the  stomach  in  a  wholly 
undigested  form.  How  different  is  the  case  with 
us  moderns.  Since  the  opening  of  the  era  of 
agriculture  and  cooking,  man  has  enormously 
multiplied  his  supplies  of  saccharide,  and  he  now 
consumes  large  quantities  of  starch  which  has 
been  freed  from  its  cellulose  framework  by  cook- 
ing, milling,  grinding,  and  the  Hke,  and  reduced 

1  My  friend,  Dr.  Thompson,  undertook,  at  my  suggestion, 
some  experiments  to  test  the  digestibility  of  raw  starch  within 
the  mouth ;  he  found  that  raw  potato  yields  abundant  sugar 
when  subjected  to  long-continued  mastication. 
[142] 


The  A.B,-Z.  of  Our  Own  Nutrition 

to  a  soft  or  pappy  form,  such  as  milk  puddings, 
porridge,  boiled  potatoes,  and  new  bread,  all  of 
which  can  be  swallowed  with  little  or  no  pre- 
liminary chewing;  and  when  food  can  be 
swallowed  easily,  without  mastication,  few  will 
take  the  trouble  to  masticate  it.  In  these  cir- 
cumstances the  starch  does  not  undergo  adequate 
salivary  digestion,  and  a  large  quantity  passes 
wholly  undigested  into,  and  out  of,  the  stomach, 
not  beginning  to  be  digested  until  it  reaches  the 
bowel.  Small  wonder  that  the  latter  should 
rebel  again  this  invasion  and  that  flatulence, 
pain,  and  other  dyspeptic  evils  should  result. 

It  is  especially  in  young  children  that  these 
evils  are  observed.  Too  often  the  stomach  of 
the  child,  semi-carnivorous,  remember,  by  its 
ancestry,  is  Hterally  deluged  with  pure  starch. 
At  the  seventh  or  eighth  month,  or  even  earlier, 
for  many  of  the  patent  infant  foods  contain  it, 
this  substance  is  poured  into  the  stomach  without 
being  afforded  any  opportunity  of  undergoing 
salivary  digestion;  and  for  a  long  time  after 
infancy  large  quantities  are  given  in  the  liquid  or 
pultaceous  form,  such  as  rusks  soaked  in  milk, 
puddings,  and  mashed  potatoes.  This  practice 
of  deluging  the  digestive  organs  with  starch, 
besides  leading  to  the  more  immediate  troubles 
connected  with  flatulent  dyspepsia,  gives  rise  to 
abundant  formation  of  toxins  which,  by  irritating 

[•43] 


The  A.B,-  Z,  of  Our  Own  Nutrition 

the  alimentary  mucous  membrane,  set  up  gastro- 
intestinal catarrh ;  this,  again,  intensifies  the 
dyspepsia  already  existing  and  causes  a  still 
further  production  of  toxins,  so  that  the  motions 
become  intensely  foetid.  These  poisons  being 
absorbed  into  the  blood  the  tissues  become 
saturated  with  them  and  the  nutrition  of  the 
entire  organism  is  disturbed,  the  faulty  meta- 
bolism manifesting  itself  by  a  diminished  resist- 
ance to  pathogenic  agencies,  by  a  tendency  on 
the  part  of  the  tissues  to  inflame  (as  shown  by  a 
liabiHty  in  children  thus  fed  to  bronchitis,  rhinitis, 
naso-pharyngitis,  and  tonsillitis),  by  their  prone- 
ness  to  tuberculosis,  and  finally  by  a  disposition 
to  rickets,  which  I  little  doubt  is  essentially  of 
toxaemic  origin. 

Besides  the  above-mentioned  troubles  an 
excess  of  starch  in  the  stomach  may  set  up 
hyperchlorhydria  —  ue.,  that  form  of  dyspepsia 
in  which  there  is  excessive  secretion  of  hydro- 
chloric acid.  This  afTection  occurs  during  the 
most  vigorous  years  of  life  and  is  apparently 
due  to  excessive  activity  on  the  part  of  the 
gastric  glands.  The  excess  of  acid  does  not 
give  rise  to  any  symptoms  so  long  as  there  is 
any  unsatisfied  proteid  in  the  stomach  to  unite 
with  it,  but  directly  all  the  proteid  is  satisfied 
and  free  acid  is  present  in  the  stomach,  pain, 
heartburn,  and  distention  are  apt  to  be  felt ;  hence 
[m4] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

these  symptoms  are  generally  removed  tempo- 
rarily by  a  meal,  the  food  ingested  seizing  upon 
the  free  acid,  and  tend  to  recur  in  the  course  of 
an  hour  or  two.  Other  symptoms  are  mental 
and  bodily  lassitude  and  great  mental  depression, 
while,  if  the  condition  is  long-continued,  gastric 
catarrh  and  dilatation  ensue.  Eructation  of  the 
acrid  mass,  its  removal  with  a  tube,  or  its  dilution 
or  neutralisation  by  an  alkali,  causes  relief  of  the 
symptoms.  Now  Dr.  WilHam  Russell,  who  has 
recently  studied  this  form  of  dyspepsia,  has 
shown,  and  the  fact  is  most  significant  from  our 
present  point  of  view,  that  in  it  starch  is  the  last 
constituent  to  leave  the  stomach ;  that  when  this 
organ  has  so  far  emptied  itself  as  to  contain  but 
one  or  two  ounces  of  very  acrid  material  the 
residue  consists  chiefly  of  finely  divided  undi- 
gested starch,  which  continues  to  stimulate  the 
gastric  secretion ;  "  and,  there  being  no  more 
proteid  with  which  to  combine,  the  secretion 
accumulates  and  leads  to  hyperacidity."  -^  Inas- 
much, then,  as  inefficient  mastication  leads  to  an 
excess  of  starch  in  the  stomach,  we  see  how  it 
may  predispose  to  hyperchlorhydria  and  we 
shall  presently  see  that  there  is  yet  another 
reason  why  it  should  do  so. 

It  will  be  gathered  from  the  foregoing  that 
thorough  mastication  is  the  most  effective  way 

1  The  Lancet,  March  21st,  1903,  p.  806. 


l^he  A,  B.-Z.of  Our  Own  Nutrition 

of  securing  efficient  starch  digestion.  This 
simple  fact  has  been  most  strangely  overlooked. 
Thus  "  van  Valzah  considers  that  not  a  little  of 
the  difficulty  of  the  digestion  of  starches  and 
cereals  can  be  overcome  by  more  thorough  cook- 
ing. Patients  who  cannot  eat  potatoes  after  ordi- 
nary cooking  are  [he  urges]  often  able  to  digest 
them  very  readily  if  they  are  doubly  cooked 
before  being  served.  Cereals,  as  a  rule,  should 
[he  contends]  be  allowed  to  simmer  all  night 
and  then  be  thoroughly  cooked  for  a  half  hour 
in  the  morning  before  being  eaten."  ^  This  is  an 
admirable  illustration  of  the  modern  tendency  to 
cheat  the  mouth  of  its  proper  work.  A  much 
more  rational  way  of  facilitating  starch  digestion 
in  those  who  experience  a  difficulty  in  this 
respect  is  by  efficient  mastication. 

Evils  resulting  from  an  insufficient  quantity 
of  alkali  in  the  stomach.  —  I  doubt  if  it  is  ade- 
quately realised  what  a  large  amount  of  alkaline 
saliva  passes  into  the  stomach  as  the  result  of 
prolonged  mastication.  Its  presence  there  serves 
the  useful  purpose  of  prolonging  the  period  of 
starch  digestion  within  the  stomach,  while  it 
further  aids  gastric  digestion  not  only  by  excit- 
ing the  secretion  of  gastric  juice,  but  also  by  its 
influence  on  the  reaction  of  the  gastric  contents; 
it  can  scarcely  be  doubted  that  the  effect  is  on 

1  Brit.  Med.  Jour.,  Epitome,  vol.  i.,  1903,  p.  45. 

[146] 


The  A,B,-Z,  of  Our  Own  Nutrition 

the  whole  one  favourable  to  digestion  in  general. 
We  have  just  seen  that  defective  mastication 
may  predispose  to  hyperchlorhydria  by  allowing 
an  excess  of  pure  starch  to  pass  into  the  stomach, 
and  I  suggest  that  it  may  further  operate  in  the 
same  direction  by  cheating  the  stomach  of  its 
due  supply  of  alkaline  saHva.  Now  the  saliva  in 
this  affection  is  apt,  as  was  pointed  out  by  Sir 
William  Roberts,  to  be  superalkaline,  and  for 
this  reason  he  recommended  his  acid-dyspeptics 
to  excite  the  flow  of  it  by  chewing  gum-mastic 
with  the  object  of  neutralising  the  gastric  hyper- 
acidity. That  relief  can  thus  be  obtained  there 
can  be  no  doubt ;  but  it  is  surely  more  rational 
to  get  the  patient  to  stimulate  his  salivary  glands 
by  masticating  actual  food,  by  which  we  secure 
the  additional  advantages  accruing  from  its  com- 
plete insalivation  and  comminution  as  well  as 
from  the  reflex  gastric  effects.  Actuated  by 
these  considerations,  I  have  long  been  in  the 
habit  of  recommending  hyperchlorhydriacs  to 
subject  their  food  to  prolonged  mastication,  this 
being,  in  my  belief,  the  most  rational  and  effective 
way  of  breaking  the  stomach  of  its  vicious  habit. 
In  extreme  cases  we  must  insist  that  each  morsel 
of  food  should  be  chewed  at  least  one  hundred 
times  and  not  permit  any  relaxation  of  this 
severe  discipline,  until  the  stomach  has  been 
schooled  into  healthier  ways. 
[•47] 


The  A,B,-Z.  of  Our  Own  Nutrition 

Evils  in  connection  with  the  jaws  and  their 
appendages  and  the  adjacent  structures  :  the  nasal 
passages^  naso-pharynx,  and  faucial  tonsils.  —  In 
those  who  do  not  masticate  properly  in  early  life 
these  parts  fail  to  develop  as  they  should,  and 
they  are  on  this  account  alone  predisposed  to 
disease ;  their  resistance  to  disease  is  still  further 
lowered  by  the  fact  of  their  blood  and  lymph 
flow  not  being  adequately  stimulated  by  the  vig- 
orous exercise  of  the  masticatory  muscles.  Now 
we  have  seen  that  the  great  cause  of  defective 
mastication  in  children  is  the  softness  of  the  food 
given  them  and  that  the  feeding  of  them  upon  an 
excess  of  soft  food,  especially  the  starchy  kind, 
disturbs  digestion,  induces  toxaemia,  and  in  this 
way  evokes  a  catarrhal  tendency.  In  children 
thus  fed  we  have  therefore  several  conditions 
which  make  for  disease  in  the  parts  under  con- 
sideration —  defective  development,  sluggish  cir- 
culation, and  toxic  saturation.  Is  it  any  wonder 
that  the  modern  child  should  be  liable  to  disease 
in  these  regions,  that  he  should  so  frequently 
suffer  from  rhinitis,  naso-pharyngitis,  tonsillitis, 
and  from  hypertrophy  of  the  pharyngeal  tonsil 
("  adenoids  ")  and  of  the  faucial  tonsils? 

It  is  in  this  way  that  I  would  explain  the 
frequency  of  adenoids  among  the  children  of 
civilised  communities.  I  claim,  in  fact,  that  this 
disease  is  largely  dietetic  in  origin.     I  submit 

[.48] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

that  a  child  whose  nasal  apparatus  and  naso- 
pharynx are  well-grown  and  habitually  bathed 
by  a  stream  of  pure  blood  and  lymph,  periodi- 
cally accelerated  by  an  ample  and  vigorous  use 
of  the  masticatory  muscles,  is  unlikely  to  con- 
tract adenoids.  On  the  other  hand,  I  contend 
that  a  child  in  whom  these  parts  are  ill-developed 
and  bathed  by  an  habitually  sluggish  stream  of 
tainted  blood  and  lymph  —  one,  ie.y  that  is  not 
only  poisoned,  but  rarely,  if  ever,  hurried  along 
its  lazy  course  by  due  exercise  of  the  muscles  of 
mastication  —  I  submit  that  such  a  child  runs 
great  risk  of  contracting  the  disease.  The 
influence  in  setting  up  adenoids  of  toxic  satu- 
ration with  its  resulting  catarrhal  tendency  is 
shown  by  the  frequency  with  which  this  affection 
follows  upon  the  rhinitis  and  naso-pharyngitis 
of  measles  and  diphtheria,  and  in  order  to  realise 
how  greatly  the  circulation  of  blood  and  lymph  in 
the  walls  of  the  naso-pharynx  must  be  influenced 
by  mastication,  one  has  but  to  remember  how 
very  closely  the  pterygoids  are  related  to  this 
region ;  in  exploring  it  for  adenoids  they  can, 
indeed,  often  be  felt  to  stand  out  prominently.^ 

"^  A  further  aid  to  the  circulation  in  the  naso-pharynx  is 
afforded  by  the  lusty  use  of  the  voice.  It  is  natural  for  the 
young  human  to  cry  and  to  shout,  and  unless  this  instinct  is 
allowed  full  play  the  child  is  apt  to  suffer  in  health.  I  cannot 
but  think  that  the  modern  child  is  too  much  repressed  in  this 
respect,  and  that  he  is  not  afforded,  especially  in  towns,  proper 

[  149] 


"The  A,B.-Z,  of  Our  Own  Nutrition 

This,  then,  is  my  explanation  of  the  truly 
fearful  prevalence  of  adenoids  among  the  mod- 
erns. It  is  essentially  a  disease  of  pap-fed 
peoples.  A  child  may,  with  the  one  exception 
that  he  is  fed  on  a  pappy,  super-saccharide  diet, 
be  brought  up  under  ideal  health  conditions. 
He  may  live  in  the  heart  of  a  dry,  open  coun- 
try, far  from  the  darkness,  dust,  and  tainted 
atmosphere  of  the  town,  sleep  with  the  win- 
dows open  all  night,  live  out  of  doors  all  day, 
be  fed  on  the  most  nourishing  (too  nourishing, 
it  may  be)  food,  be  clothed  after  the  most  ap- 
proved methods,  and  yet,  in  spite  of  all  this, 
we  may  find  his  naso-pharynx  packed  with 
adenoids.  This  disease  is,  in  fact,  scarcely  less 
prevalent  in  the  country  than  in  the  towns, 
scarcely  less  common  among  the  rich  than 
among  the  poor.  Yet  in  primitive  communities 
it  is  practically  unknown.  And  what,  I  would 
ask,  is  the  one  condition  in  the  material  environ- 
ment of  my  supposititious  child  differing  from 
that  of  the  primitive  child  ?  What  but  the  factor 
of  diet?  Therefore,  I  say,  the  prevalence  of  ade- 
noids among  moderns  must  be  the  result  of  the 
modern  system  of  feeding  children,  and  the  de- 
fective mastication  which  goes  along  with  it. 

That   the   foregoing   is   a  grave  indictment 

opportunity  of  venting  his  vocal  energy  in  out-door  play.  May 
we  not  have  here  a  contributory  factor  in  the  causation  of 
adenoids  ? 


T^he  A,B.-Z.  of  Our  Own  Nutrition 

against  that  system,  it  need  scarcely  be  said. 
For  adenoid  disease  is  fraught  with  many  evils, 
among  them  mental  hebetude,  blocking  of  the 
Eustachian  tubes,  and  manifold  other  auditory 
troubles,  gastro-intestinal  disturbances  from  the 
passage  into  the  stomach  of  unhealthy  dis- 
charges, and,  most  serious  of  all,  nasal  ob- 
struction and  consequent  mouth-breathing.  So 
serious  are  the  evils  connected  with  this  latter 
habit  that  they  demand  more  than  a  passing 
reference.  Pronounced  adenoid  disease  is  al- 
ways associated  with  mouth-breathing,  and 
there  can  be  no  doubt  that  in  the  majority  of 
these  cases,  the  nasal  obstruction  is  not  in  the 
nasal  passages  primarily,  but  is  due  to  a  block- 
age of  the  posterior  nares  by  the  adenoid 
growths,  for  it  generally  happens  that  nasal 
breathing  is  rapidly  re-established  after  their 
removal,  though  in  a  certain  proportion  of 
cases  the  obstruction  still  persists,  and  has  to  be 
dealt  with  by  treatment  directed  to  the  nasal 
passages  themselves.  Some  have,  indeed,  con- 
tended that  a  primary  nasal  obstruction  is  one 
important  factor  in  the  induction  of  adenoids, 
leading  as  it  does  to  a  dry-cupping  of  the  naso- 
pharynx during  inspiration  and  to  a  conse- 
quent congestion  of  its  lining  membrane.  I  am 
quite  ready  to  allow  that  this  mechanism  may 
play  some  part  in  causation,  and  such  an  assump- 


The  A,B,-Z,  of  Our  Own  Nutrition 

tion  is  in  entire  harmony  with  my  main  conten> 
tion  that  adenoid  disease  is  of  dietetic  origin,  for 
nasal  obstruction  in  children,  other  than  that 
caused  by  adenoids,  is  mainly  due  to  defective 
development  of  the  nasal  passages  coupled  with 
inflammation  of  their  lining  membrane,  both  of 
which  conditions  may,  as  we  have  seen,  be  es- 
sentially the  outcome  of  defective  diet. 

Coming  now  to  the  evils  resulting  from  mouth- 
breathing,  we  have  first  to  remember  that  nor- 
mally the  air  is  inhaled  through  the  nose,  and  is 
thus  warmed,  moistened,  and  filtered  before 
being  allowed  to  pass  into  the  lungs ;  but  in  the 
mouth-breather  the  air,  which  may  be  dry, 
cold,  and  dust-laden,  passes  at  once  unpre- 
pared through  the  mouth  into  the  lungs,  im- 
pinging in  its  passage  against  the  pharynx, 
thus  drying  and  mechanically  irritating  the 
mouth,  pharynx,  larynx,  and  bronchial  tubes, 
all  of  which  are  thereby  predisposed  to  disease. 
In  this  way  laryngitis  and  bronchitis,  nay,  even 
phthisis,  may  be  induced.  Dental  caries  is  also 
predisposed  to  by  the  habit  of  breathing  through 
the  mouth.  Mouth-breathing  further  interferes 
with  the  proper  development  of  the  cranial 
bones,  but  especially  of  the  maxilla,  giving  rise 
to  what  may  be  termed  the  "  mouth-breather's 
jaw,"  so  characteristic  is  it.  I  do  not  propose 
to  discuss  here  the  mechanism  by  which  this 


The  A.B,-Z.  of  Our  Own  Nutrition 

deformity  is  produced,  interesting  though  the 
question  is ;  suffice  it  to  say  that  nasal  breathing 
is  essential  to  the  normal  development  of  the 
jaws.  The  deformity  in  question,  though  it  in- 
volves the  maxilla  chiefly,  affects  also  the  man- 
dible from  the  fact  of  its  being,  to  a  large  extent, 
moulded  on  the  maxilla;  in  typical  cases  the 
maxilla  is  small  and  its  alveolar  ridge  does 
not  attain  its  normal  length,  but  is  compressed 
laterally  towards  the  sagittal  plane,  giving  rise 
to  the  false  appearance  of  a  "  high  arch  "  and 
often  thrusting  the  anterior  portion  of  the  ridge 
forwards ;  the  teeth,  the  growth  of  which  is  not 
so  much  interfered  with  as  that  of  the  imbedding 
bone,  are  thus  prevented  from  taking  up  their 
proper  positions  and  show  irregularity,  some- 
times extreme.  Dental  irregularity  may  also,  as 
we  shall  see,  result  from  inadequate  use  of  the 
jaws  in  mastication,  but  not  to  the  extent  which 
is  frequently  observed  in  the  mouth-breather's 
jaws,  and  therefore  pronounced  dental  irregular- 
ity always  shows  that  there  has  been  protracted 
nasal  obstruction,  and  this  in  the  vast  majority 
of  cases  implies  the  existence  of  adenoids,  past 
or  present ;  I  say  in  the  **  vast  majority,"  for  in 
a  few  rare  cases  long-continued  nasal  obstruc- 
tion in  children  originates  primarily  in  the  nose 
and  may  lead  to  the  typical  mouth-breather's 
jaw,  with  the  resulting  dental  irregularity. 
[>S3] 


The  A,B,-Z,  of  Our  Own  Nutrition 

The  tongue.  —  If  the  tongue  is  not  properly 
exercised  in  childhood  and  youth,  we  find  it 
imperfectly  developed ;  hence  in  inefficient  mas- 
ticators it  is  generally  small.  It  must  not  be 
forgotten  in  this  connection  that  this  organ  is 
considerably  exercised  when  the  infant  is  at  the 
breast,  from  which  the  milk  is  obtained,  not  by 
suction,  but  by  a  vigorous  tugging  and  squeez- 
ing of  the  nipple  (in  which  the  tongue  takes 
considerable  part),  whereby  the  gland  is  reflexly 
excited  to  secrete.  When,  on  the  other  hand, 
the  child  feeds  at  the  bottle  he  obtains  his  milk 
by  actual  suction,  and  generally  through  an 
orifice  of  such  ample  dimensions  as  to  allow 
the  bottle  to  be  rapidly  emptied  with  compar- 
atively little  exercise  of  the  lips  and  tongue. 
In  short,  the  breast-fed  infant  has  to  do  some 
work  for  his  living,  and  that  of  a  sort  calculated 
to  promote  the  health  of  the  jaws  and  their  ap- 
pendages, while  the  bottle-fed  child  can  glut 
himself  by  doing  very  little  more  than  opening 
his  mouth ;  wherefore  we  find  the  tongue  and 
adjacent  parts  less  developed  in  the  latter  than 
in  the  former.  It  may  be  thought  to  be  a  mat- 
ter of  indifference  whether  the  tongue  develops 
to  its  normal  proportions  or  remains  small,  but 
such  is  by  no  means  the  case,  for,  as  Dr.  J.  Sim 
Wallace  has  shown,  the  pressure  of  this  struc- 
ture against  the  teeth  promotes  the  normal 
[154] 


The  A.B.-Z,  of  Our  Own  Nutrition 

development  of  the  jaws,  especially  of  the  man- 
dible, and  when  it  is  small  they  are  apt  to  be 
so  too. 

The  salivary  glands.  —  Just  as  mastication 
increases  the  functional  activity  of  the  salivary 
glands  and  buccal  glands  and  favours  their  nor- 
mal development,  so,  contrariwise,  inefficient 
mastication  during  early  life  fails  to  call  forth 
their  normal  functional  activity  and  to  secure 
their  adequate  development.  Thus  we  find 
that  a  child  who  has  been  brought  up  on  hard, 
starchy  foods,  necessitating  abundant  mastica- 
tion has  much  larger  and  more  active  salivary 
glands  than  one  who  has  been  fed  on  soft  foods 
which  slip  down  into  the  stomach  before  they 
have  had  the  chance  of  being  properly  masti- 
cated, and  it  is  needless  to  say  that  the  more 
efficient  these  glands  are  the  more  likely  is 
digestion  to  be  carried  out  satisfactorily. 

The  jaw-bones.  —  If  the  jaws  are  not  ade- 
quately exercised  in  youth  by  mastication  they 
fail  to  grow  to  their  normal  size  and  shape,  and 
there  is  apt  in  consequence  to  be  overcrowding 
of  the  teeth.  The  main  defect  of  the  jaws  in 
such  cases  is  their  smallness ;  they  do  not  pre- 
sent that  pronounced  lateral  compression  and 
anterior  protrusion  which  characterise  the 
mouth-breather's  jaw,  nor  such  extreme  dental 
irregularity,  the  most  common  being  overlap- 


The  A,B.'  Z.  of  Our  Own  Nutrition 

ping  of  the  incisors,  displacement  of  the  canines, 
and  difficulties  in  regard  to  the  eruption  of  the 
wisdom  teeth  from  shortness  of  the  alveolar 
ridge.  I  have  already  referred  to  the  progres- 
sive shortening  in  the  post-molar  ridge,  which 
has  been  taking  place  during  man's  evolution 
from  the  anthropoid  in  correspondence  with  the 
alteration  in  his  diet. 

We  thus  see  that  defective  use  of  the  jaws 
leads  to  irregularity  of  the  teeth  (i)  directly 
and  (2)  indirectly  through  the  induction  of 
adenoids.  This  irregularity  is  not  only  un- 
sightly but  leads  to  certain  evils  which  thus  pri- 
marily owe  their  origin,  in  large  measure  at 
least,  to  defective  mastication.  What,  then,  are 
these  evils?  In  the  first  place,  dental  irregular- 
ity predisposes  to  dental  caries  by  favouring  the 
lodgement  of  food  between  the  teeth;  in  the 
next  place,  it  leads  to  defective  "  bite."  Now 
when  the  bite  is  defective  adequate  mastication 
is  impossible,  for  not  only  is  it  impossible  in 
these  circumstances  to  oppose  the  teeth  prop- 
erly, but  also,  owing  to  their  interlocking,  to 
accomplish  that  free  lateral  movement  of  the 
lower  teeth  against  the  upper,  which  belongs  to 
normal  mastication.  I  do  not  say  that  defective 
bite  is  the  sole  cause  of  this  imperfect  lateral 
movement;  it  may,  indeed,  be  observed  in 
most  moderns  brought  up  on  soft  pappy  food, 
[>S6] 


The  A,  B,-Z.of  Our  Own  Nutrition 

whether  the  bite  be  good  or  not.  Normal  mas- 
tication is,  in  fact,  becoming  a  lost  art;  the 
average  modern  masticates  mainly  by  a  verti- 
cal compression  of  the  lower  teeth  against  the 
upper,  and  in  only  a  small  degree  by  a  lateral 
frictional  movement  which,  it  is  needless  to  say, 
is  the  more  effective  method  for  grinding  pur- 
poses; and  it  is,  I  doubt  not,  chiefly  for  this 
reason  that  the  teeth  of  modern  man  are  so 
much  less  worn  down  than  those  of  primitive 
peoples. 

The  teeth.  —  Imperfect  use  of  the  teeth  leads 
to  many  ills.  When  adequately  exercised  and 
made  to  execute  for  one  or  two  hours  every 
day  a  lively  dance  in  their  sockets,  during 
which  the  circulation  of  blood  and  lymph  in 
the  tooth-pulp,  periodontal  membrane,  and  sur- 
rounding tissue  of  the  gum  is  vigorously  stimu- 
lated, and  the  cavity  of  the  mouth  is  bathed 
in  a  copious  flow  of  salivary  and  other  buccal 
secretions,  we  have  conditions  which  make  alike 
for  the  health  of  the  buccal  mucous  membrane, 
of  the  teeth,  and  of  the  periodontal  membrane 
and  alveoli ;  but  when  the  circulation  is  not  duly 
stimulated  in  this  way  the  teeth  do  not  develop 
properly,  while  the  secretions  of  the  mouth  are 
apt  to  be  scanty  and  unhealthy,  both  of  which 
conditions  predispose  to  caries.  How  far  dental 
caries  is  due  to  inherent  dental  weakness  and 
[157] 


T^he  A,B,-Z,  of  Our  Own  Nutrition 

how  far  to  faulty  conditions  outside  the  teeth 
we  need  not  stop  to  inquire ;  Dr.  Wallace  attri- 
butes little  influence  to  the  former  factor,  con- 
tending that  caries  depends  essentially  upon 
faulty  dental  environment ;  and  one  can  scarcely 
doubt  that  the  state  of  the  gums  and  of  the  oral 
secretions  profoundly  influences  the  growth  of 
bacteria  in  the  mouth,  upon  the  acid  yielded  by 
which  organisms  the  corrosion  of  the  dental 
enamel  essentially  depends.  Faulty  conditions 
of  the  oral  secretions  likewise  favour  the  deposit 
of  tartar. 

Another  result  of  imperfect  use  of  the  teeth 
is  undue  thinness  of  the  alveolar  walls  and  perio- 
dontal membrane,  in  consequence  of  which  the 
teeth  are  not  so  firmly  held  in  their  sockets  as 
they  should  be.  This  is,  I  believe,  one  of  the 
reasons  why  they  are  prone  to  fall  out  prema- 
turely among  the  moderns:  we  know  that  the 
teeth  tend  to  drop  out  in  old  people  owing  to  a 
senile  atrophy  of  the  alveolar  walls ;  the  Haver- 
sian canals  get  smaller  and  may,  indeed,  disap- 
pear entirely,  and  it  stands  to  reason  that  this 
atrophy  must  be  hastened  by  inefiicient  exer- 
cise of  the  teeth.  So  far  as  I  am  able  to  gather 
from  an  examination  of  skulls  in  museums,  the 
teeth  are  rarely  shed  among  primitive  peoples 
before  extreme  old  age,  while  among  moderns 
they  frequently  fall  out  long  ere  this  is  attained. 

[•58] 


The  A.B.-Z,  of  Our  Own  Nutrition 

A  still  worse  evil  attaching  to  insufficient 
use  of  the  teeth  is  pyorrhcea  alveolaris  or 
Riggs's  disease,  which,  in  conjunction  with  the 
deposit  of  tartar,  is  the  great  cause  of  the  pre- 
mature loosening  and  shedding  of  the  teeth 
observed  among  latter-day  civilised  peoples. 
This  affection  consists  of  a  purulent  inflamma- 
tion of  the  periodontal  membrane,  owing  to  the 
invasion  of  it  by  pyogenic  cocci,  so  that  pus 
wells  up  on  pressing  the  gum  against  the  teeth. 
Now,  when  by  a  vigorous  use  of  the  teeth  the 
buccal  cavity  is  kept  well  flushed  with  healthy 
secretions,  the  growth  of  micro-organisms  within 
this  chamber  is  kept  down,  and  when,  by  the 
same  means,  the  vitality  of  the  periodontal 
membrane  and  adjacent  tissues  of  the  gum  is 
periodically  stimulated,  these  tissues  offer  stout 
resistance  to  the  invasion  of  pathogenic  organ- 
isms ;  but  when,  contrariwise,  the  teeth  are  little 
used,  the  secretions  of  the  mouth  are  in  conse- 
quence defective  both  as  to  quality  and  quan- 
tity, and  the  growth  of  organisms  in  the  buccal 
cavity  is  promoted ;  and  when,  further,  the  cir- 
culation in  the  periodontal  membrane  and  adja- 
cent soft  tissues  is  not  adequately  stimulated  by 
vigorous  mastication,  their  vitality  is  poor  and 
they  offer  but  a  feeble  resistance  to  parasitic 
invasion.  We  can  thus,  I  think,  safely  infer  that 
inefficient  mastication  is  a  potent  cause  of  pyor- 

[159] 


The  A,  B,-Z,  of  Our  Own  Nutrition 

rhcEa  alveolaris ;  and  the  chief  cause  of  ineffi- 
cient mastication  being  the  eating  of  soft  foods, 
we  must  also  conclude  that  the  latter  practice 
is  chiefly  responsible  for  the  disease  in  ques- 
tion ;  such  foods  further  predispose  to  this  affec- 
tion in  that  they  are  apt  to  lodge  between  the 
teeth  and  by  undergoing  decomposition  there 
to  favour  the  growth  of  micro-organisms  within 
the  mouth.  The  condition  of  the  teeth  and 
gums  among  the  civilised  poor  is,  alas,  little  cal- 
culated to  make  us  proud  of  our  boasted  civili- 
sation—  the  spongy  pus-exuding  gums,  the 
lengthening,  loose,  tartar-covered,  carious  teeth, 
and  the  putrescent  breath  constitute  a  damning 
indictment  against  our  modern  system  of  living 
on  a  soft,  pappy  diet,  and  not  giving  the  teeth 
the  work  for  which  they  are  designed.  I  never 
examine  such  a  mouth  without  being  impressed 
with,  and  I  may  add  oppressed  by,  this  fact. 

I  am  not,  of  course,  contending  that  pyor- 
rhoea alveolaris  only  occurs  in  those  who  masti- 
cate inefficiently ;  whatever  causes  an  unhealthy 
condition  of  the  gums  and  saliva  predisposes  to 
it,  but  it  is  surely  much  less  common  in  those 
who  masticate  well  than  in  those  who  masticate 
ill.  Confirmatory  of  this  statement  is  the  fact 
that  it  is  more  frequent  in  those  with  irregu- 
lar teeth  than  in  those  with  a  good  bite,  who 
are  thus  able  to  put  their  teeth  to  more 
[i6o] 


T^he  A,B.'Z,  of  Our  Own  Nutrition 

effective  use.  This  affection  is  very  common 
among  the  carnivora  of  menageries  as  well 
as  among  dogs  and  cats;  indeed,  one  seldom 
fails  to  find  it  in  dogs  over  four  years  of  age, 
and  in  old  dogs  it  is  generally  rampant.  Doubt- 
less in  all  these  cases  the  general  conditions  of 
life  play  some  part  in  the  causation  of  the  dis- 
ease, but  I  do  not  think  that  we  can  eliminate 
from  it  the  factor  of  defective  use  of  the  jaws 
and  teeth,  for  it  is  certain  that  dogs  and  cats 
are  fed  largely  on  pappy  foods  and  are  often 
insufficiently  supphed  with  bones. 

The  causation  of  dental  caries.  —  Dr.  Wallace, 
in  his  philosophical  work  on  "The  Cause  and 
Prevention  of  Decay  in  Teeth,"  contends  that 
the  cause  of  the  prevalence  of  dental  caries  is 
that  the  natural  food-stuffs  are,  to  a  large  extent, 
ridded  of  their  accompanying  fibrous  parts  and 
consumed  in  a  form  which  renders  them  liable 
to  lodge  and  to  undergo  acid  fermentation  in 
the  mouth ;  while  from  the  same  cause  and  the 
induced  conditions  the  micro-organisms  of  the 
mouth  lodge  and  multiply  and  augment  the  ra- 
pidity and  intensity  of  the  acid  fermentation. 
I  am  perfectly  at  one  with  Dr.  Wallace  in  be- 
lieving that  the  removal  of  the  fibrous  portions 
of  food  is  the  main  cause  of  the  prevalence  of 
caries  among  moderns,  and  I  can  hardly  doubt 
that  foods  so  prepared  tend  to  promote  caries 

II  [  i6i  ] 


T^he  A,B.-  Z.  of  Our  Own  Nutrition 

in  the  way  indicated,  but  I  venture  to  think  that 
they  do  this  even  more  by  failing  to  call  forth 
the  normal  degree  of  mastication.  I  cannot  but 
think  that  if  these  same  soft  foods  were  as  labo- 
riously masticated  as  they  would  need  to  be  if 
they  retained  their  fibrous  ingredients,  dental 
caries  would  be  much  less  common  than  it  actu- 
ally is.  I  have  endeavoured  to  show  how  very 
different  the  local  conditions  are  in  the  efficient 
from  what  they  are  in  the  inefficient  masticator 
—  how  in  the  former  the  jaws  and  teeth  are 
wont  to  be  well  developed,  the  bite  to  be  good, 
and  the  secretions  which  bathe  the  teeth  to  be  of 
a  kind  calculated  to  promote  their  health ;  and 
how  in  the  latter  an  entirely  opposite  set  of  con- 
ditions is  wont  to  prevail.  That  it  is  possible 
to  maintain  a  fine  set  of  healthy  teeth  till  past 
middle  Hfe  on  ordinary  civilised  diet,  provided 
the  food  be  habitually  subjected  to  efficient 
mastication,  is  shown  in  the  case  of  the  man 
already  referred  to,  and  by  numerous  other  cases 
which  I  have  observed. 

Since  the  application  of  cooking  to  food 
there  has  been  a  progressive  lessening  in  the 
work  of  the  jaws  and  teeth  and,  parallel  with  this, 
a  diminution  in  their  size  and  an  incursion  of 
dental  caries.  Among  the  anthropoids  in  their 
natural  state  caries  is  practically  unknown,  and 
I  think  we  may  conclude  that  the  same  was  true 

[.62] 


7 he  A.B,-  Z,  of  Our  Own  Nutrition 

of  man  before  he  learnt  to  cook.  In  the  pre- 
agricultural  races,  such  as  the  aboriginal  Aus- 
tralians, the  effect  of  cooking  the  food  is  shown 
in  the  lessening  in  the  size  of  the  wisdom  teeth 
and  of  the  post-wisdom  alveolar  ridge;  dental 
caries,  though  rare  among  these  people,  does 
occur,  and  especially  in  the  wisdom  teeth.^ 
In  the  early  agricultural  period,  owing  to  the 
increasing  softness  of  the  vegetable  food,  the 
jaws  and  teeth  show  a  tendency  to  be  smaller 
than  in  the  previous  periods ;  the  wisdom  teeth 
are  decidedly  smaller  and  more  prone  to  caries, 
while  caries  of  the  other  teeth  is  by  no  means 
rare.  In  the  late  agricultural  period  the  jaws 
and  teeth  often  show  very  decided  defects  of 
development,  while  dental  caries  is,  as  we  know 
but  too  well,  rampant. 

What  has  been  said  concerning  the  relative 
prevalence  of  caries  in  different  diet  epochs  ap- 
plies to  many  other  diseases  of  the  teeth ;  thus, 
along  with  the  increase  of  caries,  there  has  been 
a  parallel  increase  in  the  prevalence  of  pyor- 
rhoea alveolaris. 

1  Among  the  Australian  skulls  I  have  examined  in  mu- 
seums caries  of  the  wisdom  teeth  —  /.  e.,  in  those  very  teeth 
which,  as  shown  by  their  atrophy,  are  least  used — is  by  no 
means  uncommon  (though  it  is  possible  that  some  of  the  skulls 
belong  to  natives  who  have  embraced  the  dietetic  customs  of 
the  white  man).  I  submit  that  this  fact  may  fairly  be  used  as 
an  argument  in  favour  of  the  view  that  inefficient  use  of  the 
teeth  predisposes  them  to  caries  by  interfering  with  their  re* 

[163] 


The  A,  B,-Z,of  Our  Own  Nutrition 

Concluding  Remarks 

I  have  now  set  forth  some  of  the  evils  result- 
ing from  inefficient  mastication.  They  are  many 
and  serious.  The  immediate  evils,  such  as 
over-eating,  indigestion,  adenoids,  dental  caries, 
^.nd  pyorrhoea  alveolaris,  are  bad  enough,  but 
when  we  consider  the  secondary  evils  to  which 
these  primary  ones  give  rise, —  and  I  have  only 
mentioned  a  few  of  them,  —  we  must  come  to  the 
conclusion  that  an  appalling  amount  of  misery 
and  suffering  may  be  saved  by  the  simple  expe- 
dient of  inculcating  the  habit  of  efficient  masti- 
cation. How  this  end  can  best  be  accompHshed 
will  be  considered  in  the  next  section. 

Section  IV.     From  London  Lancet,  August  8,  1903 

Means  of  Insuring  Adequate 
Mastication 

In  order  to  secure  the  full  advantages  accru- 
ng  from  the  use  of  the  jaws  and  their  append- 
ages, it  is,  above  all,  necessary  for  them  to 
be  adequately  exercised  during  the  period  of 
development.  If  this  is  done,  not  only  will 
the  tendency  to  dental  caries,  adenoids,  indiges- 

sisting  power,  though  it  must  be  acknowledged  that  the  posi- 
tion of  the  wisdom  teeth  places  them  at  a  disadvantage,  owing 
■J:o  the  tendency  of  food  to  accumulate  about  them,  especially 
n  undeveloped  jaws  in  which  they  have  not  adequate  room. 

[.64] 


The  A.B,-Z.  of  Our  Own  Nutrition 

tion,  and  other  evils  be  greatly  diminished,  but 
the  masticatory  instinct  will  establish  itself  as  a 
permanent  force,  so  that  the  individual  will  tend 
for  the  rest  of  his  life  to  subject  even  soft  foods 
to  thorough  mastication.  The  tongue,  the  lips, 
and  the  jaws  of  the  newly  born  child  find  their 
natural  exercise  at  the  mother's  breast,  and  we 
should,  therefore,  do  our  utmost  to  get  the 
mother  to  suckle  her  child,  the  bottle  affording 
neither  the  same  kind  nor  the  same  amount  of 
exercise.  If,  unhappily,  we  fail  in  this,  we  must 
see  that  the  teat  of  the  feeding-bottle  is  so  con- 
structed as  to  compel  the  child  to  earn  his  meal 
by,  at  any  rate,  some  exercise.  This  kind  of 
exercise  promotes  the  growth  of  the  tongue  and 
thus  of  the  jaws,  especially  of  the  mandible. 
Directly  the  infant  shows  a  disposition  to  bite 
hard  things  the  instinct  should  be  gratified.  We 
may  observe  a  tendency  in  this  direction  as 
early  as  the  third  or  fourth  month,  and  it 
becomes  more  and  more  pronounced  when,  the 
time  for  the  eruption  of  the  teeth  approaching, 
the  gums  begin  to  swell  up  and  to  get  tender, 
and  saliva  begins  to  flow  from  the  mouth;  it  is 
now,  more  than  ever,  necessary  to  provide  the 
child  with  hard  substances  on  which  to  exercise 
the  jaws  and  the  gums,  and  a  great  deal  of  the 
trouble  of  teething  is  due  to  the  failure  to  recog- 
nise this  fact.     What,  then,  are  we  to  employ 


The  A,B.-Z,  of  Our  Own  Nutrition 

for  this  purpose?  I  am  convinced  that  it  is  a 
mistake  to  rely  solely,  or  even  mainly,  upon 
baubles  of  ivory,  coral,  and  the  like,  useful 
though  these  may  be  in  their  way;  it  is  far 
better  to  give  the  child  something  which  is  not 
only  hard  but  nutrient  and  pleasant  to  the  taste, 
something  which  will  at  one  and  the  same  time 
exercise  the  maxillary  apparatus,  excite  the 
gustatory  organs,  and  provide  a  certain  amount 
of  nutriment.  To  this  end  we  may,  as  the  teeth- 
ing time  approaches,  give  a  chop  or  chicken 
bone,  from  which  most  of  the  meat  has  been 
removed;  by  powdering  the  bone  with  white 
sugar  or  salt  we  may  increase  its  attractiveness. 
From  such  bones  a  good  deal  of  nutriment  can 
be  extracted,  and  this  of  a  kind  which  is  most 
acceptable  to  the  infant  stomach,  for  it  must  be 
remembered  that  the  young  human  is  in  the 
main  carnivorous.  Indeed,  since  milk  is  a  purely 
animal  diet,  all  the  mammals  must  be  regarded 
as  essentially  carnivorous  during  the  period  of 
suckling,  while  man,  as  already  observed,  from 
the  time  he  emerged  from  the  anthropoid  until 
he  learned  to  cook  his  food,  was  throughout  life 
mainly  an  animal  feeder.  Therefore  we  should 
not  hesitate  to  allow  the  teething  infant  animal 
food  in  the  form  suggested.  Chicken  and  chop 
bones,  yielding  as  they  do  before  the  pressure 
on  the  gums,  are,  moreover,  just  of  the  right 
[i66] 


T^he  A.B.-Z,  of  Our  Own  Nutrition 

degree  of  consistence  for  the  purpose  in  view, 
while  they  afford  abundant  exercise  for  the 
tongue;  ivory,  coral,  and  the  like  are,  on  the 
other  hand,  too  hard  and  unyielding,  and  lack, 
moreover,  the  attractiveness  belonging  to  sa- 
pidity. 

By  thus  providing  the  maxillary  apparatus 
with  suitable  exercise  we  shall  do  much  to  facil- 
itate the  eruption  of  the  teeth  and  to  favour  the 
growth  of  the  jaws  and  their  appendages,  in- 
cluding the  salivary  glands,  and  so  to  prepare 
the  mouth  for  the  reception  of  vegetable  food. 
This  should,  of  course,  not  be  given  till  the 
teeth  appear.  The  order  in  which  these  make 
their  appearance  gives  some  indication  as  to  the 
order  in  which  vegetable  food  should  be  admin- 
istered to  the  child.  The  first  teeth  to  penetrate 
the  gums  are  the  lower  incisors  which  appear 
from  the  sev^enth  to  the  eighth  month;  then 
follow  the  upper  incisors  from  the  seventh  to  the 
tenth  month.  These  teeth  enable  the  child  to 
bite,  but  not,  be  it  observed,  to  masticate,  for 
which  function  the  molars  are  necessary.  Now 
the  first  molars  do  not  appear  till  the  twelfth  or 
fourteenth  month;  the  second  molars  not  till 
between  the  fourteenth  and  the  twentieth  month ; 
and  it  seems  to  me  certain  that  our  primitive 
ancestors  could  not  have  obtained  starch  in  any 
quantity  until  they  reached    this   age;    at   the 

[167] 


T^he  A,B.-Z.  of  Our  Own  Nutrition 

best,  pre-cooking  man  was  but  scantily  supplied 
with  starch,  and  such  slender  supply  as  he  had 
could  only  be  rendered  accessible  to  the  diges- 
tive juices  by  vigorous  mastication,  which  broke 
up  the  indigestible  cellulose  framework  in  which 
all  vegetable  starch  is  contained ;  hence,  until 
the  young  human  cut  his  molars,  he  had  Httle 
opportunity  of  securing  any  starch.  These  con- 
siderations strongly  suggest  the  desirability  of 
giving  but  small  quantities  of  starch  before  the 
twelfth  month,  and  though  the  facts,  that  ptyaline 
appears  in  the  saliva  about  the  time  the  first 
incisors  are  cut,  and  that  pancreatic  juice  de- 
velops its  amylolytic  ferment  at  the  same  time, 
show  that  the  digestive  organs  are  ready  for  the 
reception  of  some  starch  at  the  seventh  or 
eighth  month,  yet  I  believe  the  quantity  should 
be  strictly  limited.  I  am  ready  to  admit  that 
the  modern  child  may  have,  indeed  probably 
has,  a  greater  power  of  digesting  starch  than 
his  remote  pre-agricultural  ancestor;  but  even 
so,  I  am  convinced  that  we  should  be  on  our 
guard  not  to  over-gorge  infants  with  this  sub- 
stance. Only  a  small  quantity  should  be  given 
before  the  twelfth  month,  and  it  should  be  grad- 
ually increased  up  to  the  twentieth  month. 

I  have  said  that  the  pre-agricultural  infant 
was  unable  to  secure  starch  in  any  quantity  by 
means  of  his  incisors.     These  teeth  enabled  him, 
[i68] 


The  A.B.-Z.  of  Our  Own  Nutrition 

however,  to  obtain  some  soluble  nutriment  from 
fruits,  and  Dr.  Sim  Wallace  has  suggested  that 
the  early  eruption  of  the  lower  incisors  is  for  the 
purpose  of  enabling  the  infant  to  pierce  the 
outer  covering  of  fruits  so  as  to  permit  him  to 
extract  the  soluble  contents  by  suction;  and, 
accordingly,  when  these  teeth  are  cut  we  may 
allow  the  child  to  bite  at  such  vegetable 
substances  as  apples,  oranges,  and  sugar-cane. 
The  latter  is  a  useful  article  of  diet  for  children, 
for  it  provides  soluble  saccharide  in  a  diluted 
form,  and  it  is  advisable  that  the  child  should 
receive  his  cane  sugar  well  diluted,  for  it  must 
be  remembered  that  before  the  agricultural 
period  man's  supply  of  pure  sugar  was  limited 
to  wild  honey  which,  consisting  as  it  does  almost 
entirely  of  mono-saccharide  (grape  sugar  and 
fruit  sugar),  is  very  easily  disposed  of  by  the 
digestive  organs.  Nowadays,  the  less  digestible 
cane  sugar  (which  is  a  di-saccharide)  is  very 
largely  consumed  in  the  undiluted  state,  in  which 
it  is  apt  to  set  up  disturbance.  When,  how- 
ever, it  is  obtained  by  chewing  the  sugar-cane, 
it  is  diluted  both  by  the  water  in  the  cane  and 
by  the  saliva,  and  I  should  like  to  see  children 
obtain  most  of  their  cane  sugar  in  this  way. 

The  consideration  of  the  conditions  obtaining 
for  pre-agricultural  man  not  only  strongly  sug- 
gests  that  the  young  human  of  to-day  should 

[169] 


T^'he  A.B.'  Z.  of  Our  Own  Nutrition 

be  given  starch  in  very  moderate  quantities  up 
to  the  twelfth  month,  but  it  points  an  even  more 
important  lesson — viz.,  that  this  substance 
should  be  given  not,  as  is  the  custom,  as  liquid 
or  pap,  but  in  a  form  compelling  vigorous  mas- 
tication, for  it  is  certain  that  early  man,  from 
the  time  he  emerged  from  the  ape  till  he  dis- 
covered how  to  cook  his  vegetable  food,  obtained 
practically  all  his  starch  in  such  a  form ;  it  can- 
not too  often  be  repeated  that  uncooked  starch 
in  the  natural  state,  locked  up  as  it  is  in  cham- 
bers of  indigestible  cellulose,  has  no  nutritive 
value ;  these  chambers  need  first  to  be  broken 
up  by  prolonged  and  energetic  chewing,  and 
in  this  way  much  or  most  of  the  starch  is  con- 
verted in  the  mouth  into  dextrines  and  maltose, 
very  little  passing  into  the  stomach  in  the  crude 
state  to  set  up  disturbance  in  that  organ  and 
later  in  the  bowel.  If  it  is  given  as  liquid  or 
pap  it  will  pass  down  as  starch  into  the  stomach, 
while  if  it  is  administered  in  a  form  which 
obliges  the  child  to  chew  it  properly,  not  only 
will  the  jaws,  the  teeth,  and  the  gums  obtain  the 
exercise  which  they  crave,  and  without  which 
they  cannot  develop  normally,  but  the  starch 
will  be  so  thoroughly  insalivated  that  much  of 
it  will  be  converted  within  the  mouth  into  mal- 
tose. How  foolish  to  upset  the  child's  digestive 
system  by  deluging  it  with  liquid  starch,  and 
[170] 


The  A.B.-Z.  of  Our  Own  Nutrition 

then  to  endeavour  to  correct  matters  by  giving 
the  malt  extract  which  the  child  can  and  should 
himself  manufacture  within  the  laboratory  of 
his  buccal  cavity. 

Clearly,  then,  the  child  should  make  his  first 
acquaintance  with  starch,  not  in  the  form  of  a 
liquid  or  pappy  patent  food,  but  in  a  solid  and 
somewhat  tough  form.  The  best  means  of 
achieving  this  end  is  occupying  my  attention, 
and  I  hope  soon  to  publish  the  results  of  my 
investigation.  Meanwhile,  I  would  point  out 
that  hard,  well-baked  crusts  constitute  a  con- 
venient form  in  which  to  administer  starch  to 
children.  A  piece  of  crust  may  be  put  in  the 
oven  and  re-baked ;  this  not  only  hardens  it  but 
helps  to  convert  the  starch  into  dextrine,  which 
is  a  stage  on  the  road  to  maltose.  If  the  crust 
be  then  cut  into  a  suitable  shape  and  spread 
with  bacon  fat  or  fresh  butter,  it  constitutes  a 
most  agreeable  morsel.  Later,  we  may  give  hard 
plain  biscuits.  The  same  principle  should  be 
acted  upon  during  later  childhood  and  youth : 
we  should  always  give,  as  far  as  possible,  the 
starch  in  a  form  compelling  abundant  mastica- 
tion. Loaves  should  be  shaped  so  as  to  give  a 
maximum  of  crust  and  a  minimum  of  crumb, 
and  should  be  baked  hard.  Such  loaves  are 
quite  as  nutritious  as  the  ordinary  ones,  and 
much  more  digestible,  containing  as  they  do  an 

[■71] 


The  A,B.'  Z.  of  Our  Own  Nutrition 

abundance  of  dextrine  and  not  a  little  maltose, 
and  compelling  efficient  mastication,  especially 
if  eaten,  as  they  should  be,  without  any  fluid. 
A  lady  who  has  the  catering  for  a  large  number 
of  girls  gives  the  bread  in  this  way,  and  she 
tells  me  that  there  is  keen  competition  for  the 
most  crusty  portions. 

I  do  not  say  that  starch  in  the  liquid  and 
pappy  form  should  find  no  place  whatever  in 
man's  dietary  at  the  present  day,  for  this  would 
imply  the  prohibition  of  porridge,  boiled  pota- 
toes, milk  puddings,  and  the  like.  We  cannot 
put  back  the  hand  of  time  and  return  to  the 
food  of  our  primitive  ancestors,  nor  is  it  desir- 
able that  we  should ;  but  we  can,  at  least,  arrange 
matters  so  that  a  large  proportion  of  the  starch 
we  consume  shall  be  in  a  form  inviting  masti- 
cation, such  as  crusts,  stale  bread,  stale  cake, 
biscuits,  and  so  forth.  The  less  children  eat  of 
pastry,  or,  indeed,  of  any  luxurious  foods,  the 
better ;  if  brought  up  on  a  healthy  dietary  and 
under  healthy  conditions  generally,  they  will 
relish  their  simple  fare  more  than  the  choicest 
dishes  of  the  epicure.  I  do  not,  I  say,  object 
to  the  child  consuming  a  certain  proportion  of 
starch  in  the  liquid  or  pultaceous  form,  for  if, 
by  bringing  him  up  on  a  rational  dietary,  his 
instinct  to  masticate  be  afforded  due  oppor- 
tunity to  develop  he  will  be  Hkely  to  subject 
[172] 


The  A,B,-Z.  of  Our  Own  Nutrition 

even  soft  vegetable  food  to  something  like 
adequate  mastication ;  this  will  tend  to  mitigate 
the  evils  associated  with  such  food,  not  only  by 
facilitating  the  digestion  of  starch,  but  by  flush- 
ing the  mouth  and  promoting  the  health  of  the 
teeth  and  buccal  mucous  membrane. 

The  question  how  far  children  should  be 
allowed  to  crack  nuts  may  here  be  considered. 
If  the  child  has  been  brought  up  on  pappy  food, 
and  has  in  consequence  brittle  and  ill-developed 
teeth,  the  cracking  of  hard  nuts  will  be  likely  to 
injure  them,  and  this  is  a  fortiori  true  if  any  of 
the  teeth  are  carious  or  "  filled."  And  not 
only  nuts  but  hard  food  of  any  kind,  such  as 
ship's  biscuits,  may  in  these  circumstances  in- 
jure the  teeth,  as  many  of  those  who  went 
through  the  recent  South  African  campaign  can 
testify.  But  if,  on  the  other  hand,  the  child  has 
from  the  beginning  been  fed  on  coarse,  hard 
foods,  so  that  the  teeth  have  been  allowed  to 
grow  dense  and  strong,  no  harm  is  likely  to 
ensue  from  cracking  such  nuts  as  filberts  and 
Spanish  nuts.  If  a  squirrel  or  a  monkey  weigh- 
ing a  few  pounds  can  do  so  with  impunity, 
surely  the  young  human  should  be  able  to 
also.  The  cracking  should,  however,  be  done 
by  the  molars,  while  such  hard  nuts  as  Brazils 
had  best  not  be  tackled  at  all. 

Animal  food  does  not  need  the  same  amount 

[173] 


The  A,B,-Z,  of  Our  Own  Nutrition 

of  mastication  as  vegetable  food,  since  it 
is  not  digested  in  the  mouth,  though  some 
contend  that  the  mixture  of  proteid  with  alka- 
line saliva  facilitates  its  subsequent  peptoni- 
sation.  Cooked  animal  food  is,  however,  all 
the  better  for  some  mastication,  owing  to  the 
coagulation  of  the  proteids,  and,  in  order  to 
insure  the  efficient  mastication  of  meat,  fish,  and 
poultry,  Dr.  Sim  Wallace  recommends  that  they 
should  be  given  in  large  pieces  cut  thin.  "  Flat 
pieces  about  one  inch  square  generally  necessi- 
tate a  certain  amount  of  mastication.  It  is 
difficult  to  swallow  large  flat  pieces  of  meat 
without  mastication,  but  when  finely  minced 
little  or  no  mastication  is  called  forth."  The 
younger  the  child  the  more  underdone  should 
the  meat  be. 

Examination  of  the  Mouth  and  Adjacent 
Parts 

If  a  child  be  brought  up  on  the  lines  indi- 
cated and  under  healthy  conditions  generally,  it 
is  tolerably  certain  that  the  maxillary  apparatus 
will  develop  normally,  that  the  teeth  will  be 
strong  and  well  opposed,  and  show  little  ten- 
dency to  disease ;  but,  inasmuch  as  the  methods 
advocated  are  but  seldom  put  into  practice,  dis- 
orders of  the  teeth,  more  especially  caries  and 
irregularities,  are  common,   and    hence  with  a 

[174] 


The  A.B.'Z,  of  Our  Own  Nutrttton 

view  to  promote  more  efficient  mastication  it  is 
always  advisable  to  examine  our  patient's  teeth. 

Each  individual  tooth  should  be  inspected  in 
a  good  light  for  the  presence  of  caries,  and  care- 
ful note  should  be  taken  of  the  "  bite,"  a  normal 
bite  implying  not  only  a  proper  opposition  of 
the  two  rows  of  teeth  but  the  capacity  of  the 
lower  ones  to  move  freely  across  the  upper; 
mere  vertical  movement  of  the  mandible  does 
not  constitute  efficient  mastication.  In  this 
connection  it  must  not  be  forgotten  that  an 
unopposed  molar  is  useless  for  purposes  of 
mastication,  and  it  is  by  no  means  rare  to  find 
in  a  mouth  several  sound  unopposed  molars 
which  are  for  this  reason  absolutely  function- 
less.  Nay,  more  than  this,  it  may  happen 
that  teeth,  perfectly  sound  ones,  too,  far  from 
helping,  may  actually  interfere  with  mastica- 
tion ;  thus,  among  the  poor,  we  sometimes  find 
all  the  teeth  gone  save  the  upper  canines  and 
the  lower  incisors,  and  the  teeth  and  gums  being 
alike  unable  to  come  into  contact,  nothing  worthy 
of  the  name  of  mastication  is  possible ;  it  would 
be  far  better  to  be  without  any  teeth  whatever, 
for  the  toothless  gums  would  then  be  permitted 
to  come  into  contact  along  their  entire  extent, 
under  which  condition  they  gradually  harden 
and  come  to  be  quite  efficient  grinding  agents. 

Next  the  gums,  the  alveoli,  and  the  roots  of 
[175] 


7 he  A,B,-  Z,  of  Our  Own  Nutrition 

the  teeth  must  be  examined,  especially  for  the 
presence  of  erosion,  tartar,  and  pyorrhoea  alveo- 
laris,  this  latter  condition  being  evidenced  by 
the  welling-up  of  pus  upon  pressing  the  gums 
against  the  sides  of  the  teeth. 

If  our  examination  of  the  mouth  discloses 
anything  likely  to  interfere  with  mastication  the 
aid  of  the  dentist  should  at  once  be  sought,  but 
every  physician  should  be  so  far  acquainted  with 
disorders  of  the  teeth  as  to  be  able  to  say,  in  the 
majority  of  cases,  at  all  events,  when  this  is 
necessary.  I  am  convinced  that  far  more  illness 
than  is  generally  supposed  is  attributable  to 
dental  defects,  and  this  even  among  the  more 
leisured  classes.  With  regard  to  pyorrhoea 
alveolaris,  it  has  to  be  remembered  that  it  not 
only  does  harm  by  causing  loosening,  lengthen- 
ing, and  shedding  of  the  teeth,  and  thus  interfer- 
ing with  mastication,  but  also  by  contaminating 
the  stomach  and  the  blood  and  thus  upsetting 
the  digestion  and  causing  constitutional  diseases, 
such  as  anaemia  and  arthritis ;  and  inasmuch  as 
poisonous  discharges  from  the  nose,  the  naso- 
pharynx, the  pharynx,  and  the  tonsils  may  act 
in  a  similar  way,  these  parts  also  should  be 
inspected  in  connection  with  the  examination  of 
the  teeth.  In  the  dust-laden  atmosphere  of 
towns  they  are  very  liable  to  disease,  and  even 
when  healthy  are  necessarily  dirtied ;  some  go 
['76] 


T^he  A.B,'Z.  of  Our  Own  Nutrition 

so  far  as  to  advise  all  town  dwellers  daily  to 
wash  out  the  nasal  passages  and  to  gargle  the 
throat ;  but,  whatever  may  be  thought  of  this,  it 
is  certain  that  under  existing  dietetic  conditions 
special  means  are  needed  in  order  to  keep  the 
mouth  and  teeth  clean.  When  man  fed  on  raw 
food  this  was  not  necessary,  the  food  itself  and 
the  copious  flow  of  sahva,  induced  by  prolonged 
mastication,  effectually  cleansing  these  parts; 
but,  under  present  conditions,  food  tends  to 
remain  within  the  mouth,  especially  between 
the  teeth  and  in  their  crevices,  and  therefore 
special  means  are  needed  to  remove  it.  This  is 
done  by  "  cleaning  the  teeth  "  and  by  rinsing  the 
mouth. 

The  tooth-brush.  —  Probably  the  ideal  method 
of  cleaning  the  teeth  is  that  adopted  by  many 
primitive  and  not  a  few  semi-civilised  peoples  — 
viz.,  rubbing  them  with  a  twig  of  wood  which 
has  been  teased  out  at  one  end  so  as  to  form  a 
sort  of  brush  by  means  of  which  the  teeth  can 
be  burnished  and  food  dislodged  from  them. 
The  modern  tooth-brush  requires  to  be  used 
with  great  caution,  as  it  is  capable  of  doing  much 
harm,  not  only  by  removing  the  mucoid  film, 
which,  according  to  Dr.  Wallace,  protects  the 
teeth  from  corroding   agencies,^  but   probably 

i  This  film  can  be  felt  by  the  tongue  as  a  somewhat  rough 
covering,  which  gives  place  to  a  smooth  surface  after  the  use 
of  the  tooth-brush. 

12  [177] 


The  A,B.'Z,  of  Our  Own  Nutrition 

also  by  injuring  the  edge  of  the  gum  and  the 
neck  of  the  teeth,  and  thus  setting  up  the  condi- 
tion known  as  "  erosion."  Certain  it  is  that 
some  of  the  best  sets  of  teeth  I  have  encountered 
have  been  wholly  unacquainted  with  the  tooth- 
brush. In  any  case  the  brush  should  be  em- 
ployed with  great  care ;  it  should  be  soft,  and 
should  always  be  drawn  away  from  the  gums 
both  on  the  inner  and  outer  aspect  of  the  teeth 
towards  the  biting  surface,  as  well  as  across  the 
latter,  never  transversely  across  the  outer  sur- 
faces, as  so  frequently  is  done.  The  object  of 
these  procedures  is  to  dislodge  any  particles  of 
food  that  may  have  collected  between  the  teeth 
or  in  their  crevices.  For  this  purpose  the  tooth- 
pick may  also  be  employed  judiciously.  In 
order  to  render  the  enamel  of  the  teeth  white  it 
is  better  to  rub  each  tooth  carefully  with  some 
soft  material,  such  as  chamois  leather,  rather 
than  to  scrub  them  with  a  brush.  Tooth-pow- 
ders should  not  be  used  as  a  matter  of  routine, 
but  only  occasionally  and  for  appearance  rather 
than  for  cleanliness,  and  should  consist  of  some 
simple  non-irritant  material.  Antiseptic  pow- 
ders and  washes  are  to  be  scrupulously  avoided, 
for  it  is  neither  desirable  nor  possible  to  render 
the  buccal  cavity  aseptic;  myriads  of  bacteria 
flourish  within  it,  many  of  which  play  a  useful 
part  as  scavengers.     The  time  of  all  others  for 

[178] 


The  A,B.'  Z,  of  Our  Own  Nutrition 

cleaning  the  teeth  is  just  before  going  to  bed, 
so  that  the  food  shall  not  be  allowed  to  decom- 
pose in  the  mouth  during  the  night.  There  will 
then  be  no  need  to  use  the  tooth-brush  in  the 
morning. 

Rinsing  the  mouth.  —  The  mouth  should  be 
rinsed  out  as  a  matter  of  routine  after  each 
meal  and  on  rising,  and  care  should  be  taken  to 
do  this  before  the  early  cup  of  tea,  so  as  not  to 
contaminate  the  stomach  with  the  buccal  secre- 
tions which  have  accumulated  during  the  night. 
Inasmuch  as  raw  vegetable  food  has  a  cleansing 
effect  on  the  teeth,  it  is  often  a  wise  plan,  espe- 
cially in  the  case  of  children,  to  finish  a  meal 
with  some  kind  of  fruit,  such  as  an  apple  or  an 
orange.  It  hardly  seems  necessary  to  insist 
upon  the  necessity  for  keeping  all  artificial 
dentures  thoroughly  clean. 


['79] 


PROFESSOR  PAWLOW'S  DEMONSTRA- 
TIONS OF  PSYCHIC  INFLUENCE  IN 
DIGESTION 

[In  presenting  a  theory  of  human  alimentation  involving 
mental  or  nervous  as  well  as  mechanical  and  chemical  factors 
which  influence  it  for  good,  it  is  not  often  that  an  author  is 
able  to  enlist  the  assistance  of  a  complete  battery  of  scientific 
confirmation  to  fortify  his  own  crude  observations  taken  direct 
from  personal  experience  in  the  study  of  natural  requirements. 

Professor  Pawlow,  with  his  marvellously  skilful  investi- 
gation of  the  workings  of  the  digestive  secretions,  and  Dr. 
Cannon  of  the  Harvard  Medical  School,  by  aid  of  persistent 
and  patient  X-ray  studies,  explain  how  it  is  that  earned 
appetite  and  thorough  mouth-treatment  of  food  are  prelimi- 
nary necessities  of  easy  digestion,  and  that  disturbance  or 
shock  of  any  sort  during  the  process  stop  digestive  proceed- 
ings and  endanger  health.  They  show  also  that  when  the 
mouth  is  used  to  do  all  that  it  can  do  in  the  work  of  digestion 
all  the  rest  is  easily  accomplished  by  the  Natural  Auto- 
matic Processes  within  the  body. 

They  both  show  that  we  have,  each  of  us,  a  certain  respon- 
sibility in  the  matter  of  right  digestion  and  healthy  nutrition, 
and  that  all  this  personal  responsibility  is  located  in  the  head, 
in  the  mind,  and  in  the  mouth,  and  that  while  the  alimentation 
is  proceeding  it  is  a  sacred  duty  to  do  our  part  right,  accord- 
ing to  the  intelligence  that  these  most  valuable  demonstrations 
teach. 

Professor  Pawlow  has  allowed  publication  of  his  lectures  in 
Russian  and  German,  and  recently  Professor  W.  H.  Thomp- 
son of  the  Physiological  Department  of  Trinity  College, 
Dublin,  has  made  an  English  translation  which  is  issued  by 
Charles  Griffin  &  Company  of  London  and  J.  B.  Lippincott  of 
Philadelphia. 

[180] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

The  author  has  to  express  special  gratitude  to  Professor 
Pawlow,  Professor  Thompson,  Messrs  Griffin  and  Lippincott 
for  permission  to  reprint  herein  some  entire  lectures  and  ex- 
tracts that  bear  especially  on  the  practical  understanding  of 
our  subject. 

Professor  Pawlow  is  one  of  the  Board  of  Scientific  Assessors 
mentioned  in  the  report  of  a  plan  for  an  International 
Inquiry  into  the  subject  of  Human  Nutrition. 

In  one  of  the  lectures,  not  here  reprinted,  Professor  Paw- 
low gives  merited  recognition  of  the  early  statements  of  the 
French  physiologist  Blondlot  relative  to  psychic  influence  on 
the  digestive  secretions  made  some  half  century  ago,  but  dis- 
credited by  physiologists  since  that  time,  owing  to  insufficiency 
of  evidence  brought  forward  in  support  of  the  statements. 

Professor  Pawlow's  acknowledgment  is  so  gracefully  ren- 
dered that  it  is  here  given  as  a  model  of  scientific  courtesy. 

"  I  have  depicted  the  work  of  the  gastric  glands  as  we  have 
seen  it  in  our  experiments,  and  as  it  has  developed  under  our 
hands.  Is  the  picture  a  new  one }  In  its  details,  yes ;  but  not 
in  its  fundamental  features.  However  singular  it  may  appear, 
the  sketch  of  this  picture  was  more  than  fifty  years  ago  out- 
lined by  physiology.  May  this  constitute  another  reason  for 
our  science  relinquishing  its  characteristic  shyness  of  new 
things  and  for  its  conversion  to  our  interpretation  of  the 
phenomena  under  consideration ! 

"  The  talented  author  of  the  Traite  Arialytique  de  la  Diges- 
tion—  Blondlot — spoke  in  plain  words  of  the  importance  of 
taking  food,  and  of  the  specific  excitability  of  the  gastric 
mucous  membrane.  The  facts  adduced  in  the  working  up  of 
his  theory  were  naturally  insufficient,  but  we  must  not  forget 
that  the  first  experiments  on  dogs  with  artificial  gastric 
fistulae  had  only  just  been  performed.  It  is  truly  incompre- 
hensible that  the  researches  of  Blondlot  and  his  views  upon 
the  secretion  of  gastric  juice  have  experienced  during  the  past 
fifty  years  no  completion,  no  additions,  but,  on  the  contrary, 
have  passed  out  of  sight,  thanks  to  the  faulty  experiments  and 
erroneous  representations  of  later  authors.  Only  in  the 
works  of  a  few  writers  —  and  those  mostly  French  —  has 
Blondlot's  theory  survived.  Of  other  investigators  we  must 
give  mention  to  Heidenhain,  who  has  enriched  the  physiology 
of  absorption  in  general,  but  more  especially,  in  connection 
[i8i] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

with  the  secretory  work  of  the  stomach,  has  discovered  many 
important  facts  and  has  given  birth  to  many  fruitful  ideas. 
From  him  proceed  the  subdivision  of  the  secretory  process 
according  to  periods  and  exciting  agencies,  as  well  as  the  sug- 
gestion that  it  would  be  important  to  investigate  the  individ- 
ual food-stuffs  in  relation  to  the  work  of  the  stomach.  Hei- 
denhain's  results  are  contained  in  his  well-known  article  on 
the  secretion  of  the  cardiac  glands  of  the  stomach,  published 
in  the  year  1879  in  Pfluger's  Archives.  The  work  of 
Blondlot  and  the  additions  of  Heidenhain  comprise  almost 
everything  of  importance  which  was  accomplished  by  physiol- 
ogy in  fifty  years  concerning  the  conditions  and  mechanism  of 
the  secretory  work  of  the  stomach  during  digestion.  Full  of 
moment,  however,  for  our  subject  was  the  obvious  error  that 
mechanical  stimulation  constituted  an  effective  excitant  of  the 
gastric  glands,  and  this  error  was  in  its  turn  a  result  of  faulty 
methods."  —  Horace  Fletcher.] 


LECTURE  IV 

GENERAL  SCHEME  OF  AN  INNERVATION 
MECHANISM  — THE  WORK  OF  THE  NER- 
VOUS APPARATUS  OF  THE  SALIVARY 
GLANDS  — APPETITE,  THE  FIRST  AND 
MOST  POTENT  EXCITER  OF  THE  GAS- 
TRIC SECRETION 

Constituent  parts  of  a  complete  innervation  mechanism — 
The  special  duty  of  the  peripheral  terminations  of 
afferent  nerves  —  The  specific  qualities  of  nerve  cells  — 
Analogy  between  the  innervation  mechanism  of  the 
salivary  glands  and  that  of  the  deeper-lying  glands 
of  digestion  —  The  exciting  agencies  of  the  nervous 
mechanism  of  the  salivary  glands ;  their  particular 
properties  —  Differences  between  the  exciting  agencies 
of  the  different  salivary  glands  —  Discussion  of  the 
sham  feeding  experiment  —  Mechanical  and  chemical 
stimulation  of  the  cavity  of  the  mouth  has  no  effect 
on  the  gastric  glands  —  The  experiment  of  Bidder  and 

[  182  ] 


The  A,B,-Z,  of  Our  Own  Nutrition 

Schmidt  relative  to  psychic  excitation  of  the  gastric 
secretion  —  Conditions  for  success  in  this  experiment 
—  The  passionate  longing  for  food  —  the  appetite  — 
alone  brings  on  the  secretory  effect  in  the  sham 
feeding  experiment. 

Gentlemen,  —  As  you  have  learned  in  the 
last  lecture,  and  also  in  part  have  seen  by  direct 
experiment,  the  nervous  system  can  influence 
the  work  of  our  glands  in  the  most  diverse 
ways.  The  vagus  nerve,  already  burdened  with 
many  duties,  has,  in  addition,  proved  itself  to 
be  an  undoubted  exciter  of  the  gastric  glands 
and  of  the  pancreas.  But  we  must  also  assign 
to  the  sympathetic  nerve  a  similar  rdle.  This  is 
a  matter  which  cannot  be  doubted,  so  far  as  the 
pancreas  is  concerned,  and  is  highly  probable 
as  regards  the  stomach.  We  also  saw  good 
reason  for  believing  that  these  two  nerves  con- 
tained two  different  classes  of  fibres,  secretory 
and  trophic,  a  condition  which  had  already  been 
proved  to  exist  by  Heidenhain  for  the  nerves  of 
the  salivary  glands.  As  a  hypothesis  we  might 
even  have  proceeded  a  step  farther  and  have 
divided  Heidenhain's  trophic  nerves  into  sepa- 
rate classes  of  secretory  fibres.  Lastly,  we  ad- 
vanced important  experimental  evidence  to 
show  the  existence  of  special  inhibitory  fibres 
to  the  glands,  and  these  fibres  also  run  in  the 
vagus,  the  list  of  whose  functions  seems  almost 
interminable. 

[•83] 


The  A.B,-Z,  of  Our  Own  Nutrition 

We  obtained  these  results  by  division  and  arti- 
ficial excitation  of  the  nerves  which  run  to  the 
glands.  But  when,  how,  and  by  what  means  these 
nerves  are  thrown  into  activity  during  the  normal 
course  of  physiological  events  remains  a  question. 

In  order  to  avoid  repetition,  and  at  the  same 
time  impart  the  utmost  clearness  to  our  repre- 
sentation, it  may  be  useful  to  bring  before  your 
minds  at  once  the  plan  of  innervation  of  a  given 
organ,  all  the  more  since  this  scheme  is  seldom 
completely  followed  out  or  adequately  described 
in  physiological  text-books.  Consequently,  it 
is  not  borne  in  mind  with  sufficient  precision  by 
the  majority  of  medical  men. 

A  complete  innervation  mechanism  consists 
of  the  peripheral  endings  of  the  centripetal 
(  afferent )  nerves,  the  centripetal  nerves  them- 
selves, the  nerve  cells  (a  group  of  nerve  cells 
connected  with  each  other  is  termed  a  "nerve 
centre  "  ),  the  centrifugal  (efferent)  nerves,  and, 
lastly,  their  peripheral  terminations.  Physiol- 
ogy now  accepts  it  as  a  settled  fact,  that  nerve 
fibres  serve  only  as  conductors  of  nervous  im- 
pulses, which  come  in  from  contiguous  links  of 
the  nervous  chain.  Only  the  peripheral  endings 
of  nerves  and  the  nerve  cells  themselves  have 
the  power  of  transforming  the  external  stimulus  ^ 

1  By  the  term  "  external  stimulus "  I  mean  here  without 
distinction  every  outward  agency  of  nature,  as  well  as  every 

[184] 


"The  A,  B.-Z.of  Our  Own  Nutrition 

into  a  nervous  impulse.  In  other  words,  in  the 
intact  organism  these  alone  constitute  the  nor- 
mal receiving  apparatus  of  the  nervous  system. 
Whether  the  peripheral  ends  of  centrifugal 
(efferent)  nerves  are  likewise  able  to  function 
as  normal  sites  for  the  application  of  external 
stimuli  has  still  to  be  answered.  Consequently, 
when  any  external  agency  excites  the  peripheral 
terminations  —  the  receiving  stations  —  of  cen- 
tripetal nerves  in  this  or  that  organ,  the  effect 
of  the  stimulus  will  be  conveyed  through  the 
centripetal  nerves,  as  through  a  receiving  wire, 
to  the  central  station  —  the  nerve  cells.  Here 
it  becomes  changed  into  a  definite  impulse  and 
now  comes  back  along  the  centrifugal  nerves — 
the  outgoing  wires. 

The  utmost  importance  is  to  be  attached  to 
the  fact  that  only  the  peripheral  endings  of  cen- 
tripetal (afferent)  nerves,  in  contrast  to  nerve 
fibres  themselves,  respond  to  specific  stimuli ; 
that  is  to  say,  are  able  to  transform  definite 
kinds  of  external  stimuli  into  nervous  impulses. 
The  function  of  the  end  organs  with  which  they 
are  connected  is  therefore  of  a  purposive  nature  ; 
in  other  words,  these  organs  are  only  called  into 
play  by  certain  definite  conditions,  and  impart 

agency  which  has  its  seat  within  the  organism.  The  word 
**  external "  applies  here  to  everything  with  the  single  excep- 
tion of  the  nervous  svstem  itself. 

[  i8S  ] 


'The  A,B.'Z.  of  Our  Own  Nutrition 

the  idea  of  being  aware  of  their  purpose,  of 
being  conscious  of  their  duty.  We  have  long 
known  that  the  peripheral  endings  of  sensory 
nerves  are  possessed  of  a  high  degree  of  special- 
ity, and  cannot  therefore  have  any  doubt  regard- 
ing the  specific  nature  of  the  end  organs  of 
other  centripetal  nerves.  This  is  a  sore  point 
in  present-day  physiology.  But,  notwithstanding 
our  knowledge  of  the  separate  parts  of  the  ani- 
mal body,  we  shall  only  be  able  to  form  a  true 
conception  of  the  motive  agencies  of  the  whole 
complicated  machine,  when  we  have  established 
the  specific  excitability  of  the  end  apparatus 
of  every  centripetal  nerve,  and  have  discovered 
all  the  mechanical,  chemical,  and  other  factors 
which  throw  this  or  that  end  apparatus  into  an 
active  condition.  I  always  look  upon  it  as  a 
period  of  scientific  inadequacy  so  long  as  the 
effects  of  the  most  diverse  external  agencies 
upon  any  normal  physiological  process  are 
admitted  to  be  indistinguishable.  As  the  work 
of  the  digestive  canal  is  now  represented  in  the 
majority  of  text-books,  and  consequently  pre- 
sented to  the  mind  of  the  physician,  it  bears  the 
impress  of  this  period.  To  impart  to  the  physi- 
cian a  more  correct  conception  of  this  matter 
was  my  chief  object  in  giving  these  lectures. 
I  hope,  indeed,  to  furnish  you  with  evidence 
sufficiently  convincing,  that  the  alimentary  canal 
[i86] 


The  A.B.-  Z,  of  Our  Own  Nutrition 

is  endowed  not  with  mere  general  excitability ; 
that  is  to  say,  does  not  respond  to  every  con- 
ceivable form  of  agency,  but  only  to  special 
conditions  which  are  different  for  the  different 
portions  of  its  length.  Just  as  men  and  animals 
in  the  world  are  only  able  to  maintain  their 
existence  and  constantly  adapt  themselves  to 
changing  circumstances  by  aid  of  the  peripheral 
endings  of  their  sensory  nerves,  so  every  organ, 
indeed  every  cell  of  every  organ,  can  only  main- 
tain its  place  in  the  animal  microcosm,  and 
adapt  itself  to  the  activity  of  innumerable  asso- 
ciates, as  well  as  to  the  general  life  of  the  whole, 
by  virtue  of  the  fact  that  the  peripheral  end 
apparatus  of  its  centripetal  nerves  possesses  a 
specific  excitability. 

The  same  applies  to  the  nerve  cells:  obvi- 
ously they  are  endowed  with  specific  sensibility. 
Irrespective  of  the  excitations  which  are  com- 
municated to  them  from  centripetal  nerves,  they 
respond,  as  originators  of  nervous  impulses, 
only  or  at  least  mainly  to  definite  forms  of 
mechanical,  chemical,  or  other  stimuli  arising 
in  the  organism.  This  follows  not  alone  from  a 
number  of  physiological  facts  but  also  from 
various  pharmacological  data.  Thus  we  learn 
that  various  drugs  excite  or  annul  the  activity 
of  definite  portions  of  the  nervous  system,  at 
least  in  the  earlier  phases  of  their  effects.  This 
[187] 


'    The  A.B,-Z.  of  Our  Own  Nutrition 

specific  excitability  of  nerve  cells,  just  as  much 
as  the  same  property  of  peripheral  end  organs, 
lies  at  the  bottom  of  the  purposive  action  of 
these  organs. 

Hence,  our  next  duty  is  to  endeavour  to 
discover  the  normal  exciting  conditions  of  the 
centripetal  nerves  belonging  to  the  glands  which 
we  had  under  consideration  in  our  last  lecture, 
or,  more  correctly,  to  find  out  the  conditions 
which  excite  the  centres,  as  well  as  the  pe- 
ripheral endings  of  the  different  nerves,  which 
form  parts  of  the  nervous  apparatus  of  these 
glands.  We  have,  therefore,  for  each  phase  of 
the  work  of  secretion,  to  find  out  that  portion 
of  the  nervous  mechanism  which  is  for  the  time 
being  under  excitation,  and  to  discover  the 
primary  agency  by  which  this  condition  is 
elicited.  This  would  include  an  exact  analysis 
of  the  stimulating  influence  which  mastication 
and  food  exert  upon  the  nervous  mechanism  of 
these  glands.  We  shall  also  be  able  more  fully 
to  comprehend  the  inner  mechanism  underlying 
the  facts  which  formed  the  subject  of  the  second 
lecture.  This,  of  course,  is  an  ideal  programme 
which  we  can  only  follow  out  as  far  as  the  pres- 
ent state  of  physiology  permits.  It  may  now 
be  instructive,  and,  for  our  further  conclusions, 
advantageous,  to  glance  shortly  at  the  nervous 
control  of  the  salivary  glands. 
[i88] 


T^he  A.  B,-Z.of  Our  Own  Nutrition 

The  salivary  glands,  whose  innervation  has 
long  ago  been  investigated,  have  generally  been 
accepted  as  types  of  the  deeper-lying  digestive 
glands,  and  when  it  became  necessary  to  form  a 
conception  of  the  mode  of  activity  of  the  latter, 
medical  science  resorted  to  a  bold  analogy  and 
thought  of  the  nervous  apparatus  of  the  salivary 
glands.  But  the  attempts  of  investigators  to 
apply  rigidly  to  others  the  scheme  of  innervation 
which  holds  good  for  the  salivary  glands,  have 
done  considerable  harm  to  the  usefulness  of  the 
analogy  and  have  prevented  our  arriving  at  a 
correct  idea  of  the  plan  of  innervation  of  the 
abdominal  glands.  We  have  already  had  an  ex- 
ample of  this  nature  before  us.  In  the  salivary 
glands  we  have  no  clearly  marked  indications  of 
nervous  inhibition,  and  this  circumstance  has 
decidely  retarded  the  due  development  of  our 
knowledge  of  the  nervous  control  of  the  abdom- 
inal glands.  Authors  naturally  expected  to 
see  a  simple  and  prompt  stimulation-effect 
from  the  same  conditions  of  experiment  which 
sufficed  for  the  salivary  glands,  and  the  failure 
of  this  gave  them,  as  they  thought,  the  right 
to  deny  the  existence  of  any  extrinsic  nervous 
influence  upon  the  abdominal  glands.  The 
error  is  now  obvious;  the  abdominal  glands 
behave  in  some  ways  different  from  the  salivary 
glands,  and  for  their  successful  investigation, 
[189] 


T^he  A.B.-  Z.  of  Our  Own  Nutrition 

other  conditions  of  experiment  are  necessary 
than  those  which  held  good  for  the  former.  In 
the  working  of  the  abdominal  glands  nervous 
inhibitory  processes  play  a  large  part,  but  they 
are  almost  wholly  absent  in  the  case  of  the 
salivary  glands.  This  is  an  additional  warning 
that  one  must  never  push  the  conclusions  drawn 
from  analogy  too  far,  but  must  constantly  bear 
in  mind  that  the  life-functions  of  all  organs  are 
extremely  complicated,  and  that  the  work  of 
even  the  most  apparently  similar  organs  should 
be  submitted  to  separate  and  careful  observation. 
To  me  it  appears  that  the  unjustified  analogy 
drawn  between  the  abdominal  and  salivary 
glands  has  to  be  credited  with  another  impor- 
tant misapprehension.  And  precisely  for  this 
reason  I  think  it  desirable  to  bring  under  con- 
sideration, if  only  in  brief  fashion,  the  conditions 
of  work  of  the  salivary  glands,  especially  since 
Dr.  Glinski  has  instituted  in  the  laboratory  some 
easily  performed  experiments  which  bear  upon 
the  matter. 

The  experiences  of  daily  life  teach  us  from 
the  outset,  that  the  activity  of  the  saHvary  glands 
begins  even  before  the  introduction  of  food  into 
the  mouth.  With  an  empty  stomach,  the  sight 
of  food  or  even  the  thought  of  it  is  sufficient  to 
set  the  salivary  glands  at  once  into  activity; 
indeed,  the    well-known   expression,  "  to  make 

[190] 


^he  A,  B.-  Z.  of  Our  Own  Nutrition 

one's  mouth  water,"  is  based  upon  this  fact. 
Hence  a  psychic  event,  the  eager  longing  for 
food,  must  be  accepted  as  an  undoubted  excitant 
of  the  nervous  centre  for  the  salivary  glands. 
On  the  other  hand,  the  same  every-day  experi- 
ence, as  well  as  numerous  experiments  upon 
animals,  teach  us  that  a  number  of  substances, 
when  brought  into  contact  with  the  mucous 
membrane  of  the  mouth,  are  likewise  able  to 
call  forth  a  secretion  of  saliva.  One  even 
acquires  the  impression  that  everything  brought 
into  the  mouth  may  reflexly  influence  these 
glands,  the  only  difference  being  a  gradual  shad- 
ing off  in  the  effect,  dependent  upon  the  strength 
of  the  stimulation  which  the  substance  introduced 
is  able  to  exert,  and  it  appears  to  me  that  it  is 
precisely  this  impression  which  has  driven  the 
idea  into  the  background,  that  the  peripheral 
end  apparatus  of  the  centripetal  nerves  of  the 
digestive  canal  are  specifically  excitable.  The 
facts  were  here  correctly  observed,  but  their 
indications  erroneously  interpreted. 

The  great  multiplicity  of  excitants  of  salivary 
secretion,  has  without  doubt,  some  connection 
with  the  complicated  physiological  functions  of 
the  saliva.  This  is  the  first  fluid  encountered 
by  everything  which  enters  the  alimentary  canal. 
It  must,  therefore,  in  a  sense  play  the  part  of 
host  to  every  substance  taken  in  —  moisten  the 

['9!] 


'The  A.B,'Z,  of  Our  Own  Nutrition 

dry,  dissolve  the  soluble,  envelop  the  hard  and 
bulky  with  mucus  in  order  to  facilitate  its  pas- 
sage down  the  narrow  CEsophagus ;  and  submit 
certain  forms  of  food  material,  such  as  starch,  to 
a  process  of  chemical  elaboration.  Nor  is  its 
duty  by  any  means  ended  here.  The  saliva  is 
secreted  in  the  first  compartment  of  the  alimen- 
tary canal,  which  is  at  the  same  time  the  sorting- 
room  of  the  organism.  Much  of  what  enters 
the  mouth  may  prove  in  the  testing  process  to 
be  useless,  or  even  noxious,  and  must  either 
have  its  deleterious  properties  neutralised  or  be 
completely  rejected.  The  saliva  is  secreted  in 
the  first  instance  to  obviate  injurious  effects  in 
some  way ;  thus,  for  example,  a  strong  acid  is  to 
a  certain  degree  neutraHsed,  while  other  corrod- 
ing substances  may  be  simply  diluted,  and  by 
mere  reduction  of  concentration  have  their 
harmfulness  diminished. 

In  the  second  place,  when  the  injurious  sub- 
stances have  to  be  wholly  removed,  the  saliva 
plays  the  rdle  of  a  washing-out  fluid ;  otherwise 
the  material,  by  clinging  to  the  mucous  mem- 
brane of  the  mouth,  might  in  longer  or  shorter 
time  gain  entry  into  the  blood  and  there  develop 
its  noxious  influence.  This  last  function  of  the 
fluid  is  hardly  taken  into  account  at  all  in 
physiology,  and  yet  it  is  evident  that  the  saliva, 
as  a  cleansing  fluid,  must  have  a  wide  importance. 
[192] 


The  A,B,'  Z,  of  Our  Own  Nutrition 

If  you  only  think  of  how  often  we  are  impelled 
to  expectorate,  that  is,  to  wash  out  the  mouth 
with  saliva  after  something  unpleasant,  this  will 
be  clear.  Such  a  view  finds  additional  support 
when  we  reflect  that  a  feeling  of  disgust  pro- 
duces almost  as  strong  a  flow  of  saliva  as  the 
sight  of-  a  tasty  meal.  In  both  cases  the  secre- 
tion performs  the  office  of  forerunner:  in  the 
first  it  prepares  for  the  washing  out  of  the 
mouth,  in  the  second  for  the  requisite  elabora- 
tion of  the  food.  Think  how  often,  when  some- 
thing disagreeable  enters  the  mouth,  with  what 
rapidity  the  saliva  is  poured  out,  even  after  the 
unpleasant  substance  has  been  for  a  considerable 
time  removed,  and  not  a  trace  more  is  apparent 
to  the  sense  of  taste.  Indeed,  long  afterwards 
one  has  only  to  recall  the  circumstances  to 
mind  in  order  to  bring  on  anew  the  secretion  of 
saliva.  Apparently  the  psychic  excitation  of  the 
nerves  of  salivary  secretion  also  ushers  in  the 
act  of  vomiting,  which,  as  is  well  known,  can  be 
called  forth  by  mental  influence.  Further,  the 
function  of  the  saliva  just  mentioned  is  probably 
the  true  physiological  explanation  of  the  feeling 
of  disgust  which  many  persons  experience  at 
the  sight  of  the  secretion  itself. 

Hence  I  hold  that  substances  which  obtain 
entry  to  the  mouth  set  up  a  secretion  of  saliva 
only  because  we  have  here  the  seat  of  a  defi- 
^3  [  193  ] 


T^he  A,B,-Z.  of  Our  Own  Nutrition 

nite  physiological  sense,  and  not  because  the 
peripheral  terminations  of  the  buccal  nerves 
are  devoid  of  specific  excitability,  and  capable 
of  being  thrown  into  action  by  every  desired 
form  of  stimulus.  In  other  words,  the  specific 
excitability  of  the  peripheral  endings  of  the 
salivary  nerves  is  very  comprehensive  and 
widely  extended.  This  is  no  picture  of  the 
imagination,  for  it  can  be  supported  by  facts. 
To  say  nothing  of  the  testimony  of  earlier  au- 
thors, that  the  salivary  glands  have  each  partic- 
ular exciting  agencies  to  which  they  specially 
respond,  we  can  demonstrate  the  following  facts 
from  the  material  collected  in  our  laboratory. 

Dr.  Glinski  isolated  the  orifices  of  the  salivary 
glands  in  dogs  with  portions  of  the  adjoining 
mucous  membrane,  brought  them  out  of  the  oral 
cavity,  and  caused  them  to  heal  into  the  edges  of 
the  skin  wounds.  In  his  first  animal  the  ducts  of 
the  submaxillary  gland  were  thus  led  outwards. 
By  means  of  a  Mendeljeff's  clip,  the  wide  end 
of  a  conical  funnel  of  waterproof  material  was 
attached  to  the  skin  surrounding  the  orifice. 
To  the  narrow  end  a  small  test-tube,  which 
served  to  collect  the  saliva,  was  attached  by  a 
wire.  I  now  offer  such  an  animal  a  piece  of 
flesh,  and,  as  you  see,  the  tube  fills  up  at  once 
with  saliva.  I  stop  tempting  the  dog,  hang  on 
a  new  test-tube,  and  give  it  a  few  pieces  of  flesh 
[  194] 


T^he  A.B.'Z,  of  Our  Own  Nutrition 

to  eat;  once  more  a  strong  secretion  of  saliva 
results.  A  new  tube  is  now  attached  to  the 
funnel,  the  dog's  mouth  is  opened,  and  a  pinch 
of  fine  sand  thrown  in ;  again  there  is  a  flow  of 
saliva.  Once  more  a  new  test-tube;  and  now 
I  apply  to  the  buccal  mucous  membrane,  the 
plume  of  a  feather  dipped  in  acid  solution,  with 
the  result  that  I  obtain  a  strong  flow  of  saliva. 
One  may  employ  a  number  of  substances  in  this 
way,  when  a  similar  effect  is  always  produced. 
You  see,  in  this,  such  a  comprehensive  excita- 
bility of  the  innervation  apparatus  of  the  salivary 
glands  that  you  might  readily  interpret  it  as 
meaning  the  power  of  response  to  all  and  sundry 
forms  of  stimulation.  We  now  proceed,  how- 
ever, to  another  dog,  whose  parotid  duct  has  in 
a  similar  manner  been  diverted  outwards.  The 
saliva  is  collected  in  the  same  way.  We  tempt 
the  dog  with  a  piece  of  flesh,  but  to  our 
astonishment  no  saliva  flows,  and  yet  the  animal 
is  most  eager  for  the  savoury  meal  offered.  Now 
we  give  it  some  raw  flesh  to  eat;  again  the 
secretion  of  saliva  is  as  good  as  absent;  only 
when  I  come  near  can  I  detect  one  or  two  drops 
of  saliva  running  down  the  sides  of  the  tube. 
Probably  you  will  say  there  is  something  wrong, 
either  with  the  method  or  with  the  glands  of  the 
animal.  But  wait  a  little.  I  now  give  the  dog 
finely  powdered  dry  flesh,  and  obtain  at  once  an 


The  A.B.'Z.  of  Our  Own  Nutrition 

abundant  secretion.  Should  any  one  happen  to 
ihink  that  the  variation  in  the  result  is  depend- 
ent, not  on  a  different  specific  activity  of  the 
glands,  but  on  individual  differences  in  the  dogs, 
I  respond  that  Dr.  Glinski  has  had  an  animal 
with  double  parotid  and  submaxillary  fistulae, 
and  was  able  to  observe  on  one  and  the  same 
dog,  a  like  behaviour  on  the  part  of  the  glands 
to  that  which  we  have  just  seen  in  two  different 
individuals.  An  analogous  experiment  with 
bread  was  also  carried  out  by  Dr.  Glinski. 
The  eating  of  fresh  moist  bread  produced  no 
secretion  worth  mentioning,  while  dry  bread,  on 
the  other  hand,  caused  the  saliva  to  flow  in 
large  quantities.  The  results  of  this  experiment 
permit  us  to  draw  extremely  instructive  con- 
clusions. In  the  first  place,  the  several  salivary 
glands  are,  as  a  matter  of  fact,  very  sharply 
differentiated  in  the  conditions  necessary  for 
their  activity — that  is  to  say,  in  respect  to  the 
agencies  which  excite  their  nervous  mechanisms. 
Secondly,  the  innervation  apparatus  of  the  pa- 
rotid manifests  a  very  sharp  selective  power  in 
the  choice,  so  to  speak,  of  an  adequate  stimulus. 
The  mechanical  effect  of  large  pieces  of  flesh  is 
naturally  much  greater  than  that  of  the  finely 
powdered  material,  and  yet  it  was  precisely  to  the 
latter  that  the  glands  responded.  The  stimulus 
is,  therefore,  not  due  to  the  mechanical,  but  to 
[196] 


The  A,B,-Z,  of  Our  Own  Nutrition 

some  other  property  of  the  food.  This  other 
property  is  obviously  the  dryness  of  the 
material.  Our  example  illustrates  how  that 
which  we  may  term  "  purposiveness "  comes 
into  play  in  the  working  of  our  glands  and  also 
how  erroneous  is  the  opinion  that  the  mechani- 
cal stimulus  is  all  potent.  Indeed,  previous 
authors  have  already  pointed  out  that  dry  sub- 
stances cause  a  specially  free  secretion  of  saliva, 
and  yet  physiological  opinion  throughout  the 
length  and  breadth  of  the  land,  as  expressed  in 
text-books,  has  chosen  to  recognise  a  universal 
instead  of  a  specific  excitability.  Dr.  Wulfson, 
who  is  at  present  carrying  on  the  investigation 
of  salivary  secretion  in  our  laboratory,  has  added 
a  very  interesting  observation  to  the  results  of 
Dr.  Glinski  already  related.  The  parotid  gland, 
which  is  hardly,  if  at  all,  excited  when  one  offers 
fresh  meat  to  the  animal,  responds  with  a  very 
active  secretion,  when  dry  food  (bread  or  pow- 
dered meat)  is  offered.  This  phenomenon  is 
all  the  more  surprising  since  the  desire  of  the 
animal  for  eating  is  much  more  strongly  excited 
by  flesh  than  by  dry  bread.  I  am  quite  con- 
vinced that  an  exact  study  of  the  exciting 
agencies  of  the  three  salivary  glands  will  furnish 
a  number  of  new  data  bearing  upon  the  question 
in  hand. 

The  second  reagent  which  is  poured  out  on 

[197] 


The  A.B.-Z.  of  Our  Own  Nutrition 

the  raw  material  in  the  digestive  canal  is  the 
gastric  juice.  How,  in  the  normal  course  of 
events,  is  the  work  of  the  gastric  glands,  which 
prepare  this  juice,  called  into  play?  With  the 
first,  and  manifestly  important  factor,  which  has 
a  relation  thereto,  you  are  already  acquainted, 
and,  indeed,  have  already  seen.  I  refer  to  the 
production  of  gastric  juice  in  the  empty  stomach, 
as  a  result  merely  of  the  swallowing  of  food  in 
the  so-called  sham  feeding  of  an  oesophagoto- 
mised  dog.  When  one  takes  into  consideration 
the  absolute  independence  of  this  factor,  and 
the  intensity  of  the  effect,  which  makes  itself 
evident  in  the  secretion  of  a  large  quantity  of 
juice  of  high  digestive  power,  the  exciting  agency 
which  brings  about  such  secretion  must  be  rec- 
ognised as  one  of  the  most  important  and  effective 
processes  in  gastric  digestion.  But  in  what  does 
it  consist  ?  At  first  sight  it  appears  —  and  when 
I  previously  drew  your  attention  to  the  fact  I 
expressed  the  opinion  —  that  there  is  here  a 
simple  reflex  effect  from  the  cavity  of  the  mouth 
upon  the  secretory  nerves  of  the  stomach,  similar 
to  the  reflex  excitation,  e.g.,  of  the  parotid  gland, 
by  finely  powdered  flesh  thrown  into  the  mouth. 
Now,  however,  I  assert  quite  emphatically  that 
this  is  not  the  case.  We  have,  it  is  true,  in  the 
activity  of  the  salivary  glands  an  analogous 
phenomenon  to  indicate  —  not,   however,   that 

[198] 


The  A.B.-Z.  of  Our  Own  Nutrition 

of  which  we  have  just  spoken.  We  might  ap- 
ply every  conceivable  form  of  stimulus  which 
could  possibly  come  into  play  in  the  act  of  eat- 
ing, and  yet  would  not  obtain  the  slightest  indi- 
cation of  secretory  activity  in  the  stomach.  In 
this  dog  with  a  gastric  fistula,  and  with  also 
a  divided  oesophagus,  I  will  try  such  an  experi- 
ment, using  the  most  effective  chemical  stimu- 
lus to  the  buccal  mucous  membrane,  viz.,  acid 
solution. 

The  secretion  of  saliva  begins  at  once,  as  you 
see ;  the  acid  is,  therefore,  effective.  From  the 
stomach,  however,  in  spite  of  continued  exci- 
tation, no  secretion  results,  although  the  acid, 
mixed  with  the  saliva,  is  swallowed  and  flows  out 
again  from  the  upper  segment  of  the  oesophagus 
—  that  is  to  say,  passes  along  precisely  the  same 
path  that  the  food  takes  in  sham  feeding. 

We  could  experiment  in  the  same  way  with 
a  number  of  other  substances:  saline,  bitters, 
pepper  (strong  local  excitation),  mustard,  and 
so  on,  and  always  with  the  same  results ;  a  free 
secretion  of  saliva,  but  perfect  quiescence  of  the 
gastric  glands.  We  may  even,  with  the  same 
object,  employ  the  soluble  constituents  of  flesh 
in  the  form  of  a  decoction,  and  likewise  observe, 
in  most  cases  at  least,  no  sign  of  activity  on  the 
part  of  the  gastric  glands. 

With  the  chemical  we  may  also  combine  a 
[199] 


l^he  A.B,-Z,  of  Our  Own  Nutrition 

mechanical  stimulus.  We  can,  for  example, 
wipe  out  the  mouth  with  a  sponge  soaked  in 
the  solution  to  be  experimented  with,  but  always 
with  the  same  negative  result.  We  may  finally 
give  such  pieces  of  sponge,  or  even  smooth 
stones  of  considerable  size,  to  the  dog  to  swal- 
low, passing  them  back  behind  the  anterior 
pillars  of  the  fauces  and  allowing  them  to  fall 
out  again,  from  the  upper  portion  of  oesophagus. 
It  may  be  added  that  a  well-taught  dog  puts  up 
with  all  these  procedures  without  the  slightest 
protest.  You  see  that  all  the  manipulations  in 
this  case  are  carried  out  with  bare  hands  and  with- 
out instrumental  aid.  One  can  easily  train  a  dog 
to  swallow  stones  which  are  placed  in  the  anterior 
part  of  the  buccal  cavity.  It  simply  makes  a 
few  chewing  movements  and  swallows  them 
down.  The  dog  on  which  the  acid  experiment 
has  just  been  made  serves  also  for  the  swallow- 
ing of  the  stones.  The  attendant  now  places 
some  pebbles  in  the  front  part  of  the  mouth, 
when  the  animal  rolls  them  round,  as  if  chewing 
and  gnawing  them,  and  then  swallows  them. 
The  stones  fall  out,  as  you  see,  from  the  oesoph- 
agus, and  drop  with  an  audible  sound  upon  the 
table.  This  play  with  the  stones  has  now  lasted 
fifteen  or  twenty  minutes  (in  the  laboratory  we 
have  often  kept  it  up  for  hours),  and  yet  not  a 
drop  of  gastric  juice  is  to  be  seen. 
[  200  ] 


The  A.B.-Z.  of  Our  Own  Nutrition 

In  order  to  prove  that  the  dog  is  perfectly 
healthy  and  normal,  we  lay  aside  the  stones  and 
proceed  to  our  old  experiment  of  sham  feeding. 
As  you  see,  the  first  drop  of  gastric  juice  makes 
its  appearance  precisely  at  the  end  of  five  min- 
utes, and  after  a  further  five  minutes  we  have 
collected  more  than  15  c.c.  of  the  fluid;  conse- 
quently there  can  be  no  doubt  that  in  this  dog 
both  gastric  glands  and  nerves  are  uninjured 
and  function  in  normal  manner.  At  one  time 
we  even  had  a  dog  which  voluntarily  took  the 
stones  out  of  one's  hand  and  swallowed  them ; 
the  sagacious  creature  had  seen  our  object  in 
previous  experiments  and  learned  to  perform  it 
of  its  own  accord !  But  in  this  case  also  the 
result  was  negative. 

Clearly,  therefore,  neither  chemical  nor  me- 
chanical stimulation  of  the  buccal  mucous  mem- 
brane is  capable  of  reflexly  exciting  the  nerves 
of  the  stomach.  Further,  it  is  obvious  that  the 
excitation  of  these  nerves  in  sham  feeding  is 
not  the  result  of  a  stimulation  coincidently  pro- 
duced ;  that  is  to  say,  the  excitement  of  the 
chewing  and  swallowing  centres  does  not  imply 
simultaneous  action  of  the  secretory  centre  of 
the  gastric  glands.  In  what,  then,  does  this 
influence  consist  which  is  intrinsic  to  the  sham 
feeding,  but  which  we  have  not  been  able  to  re- 
produce in  our  analytical  investigation?  There 
[201] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

is  only  one  thing  to  think  of,  namely,  the  eager 
desire  for  food,  and  the  feeling  of  satisfaction 
and  contentment  derived  from  its  enjoyment. 

It  has,  indeed,  been  known  for  forty  years, 
thanks  to  the  experiments  of  Bidder  and 
Schmidt,  that  at  times,  the  offering  of  food  to 
a  hungry  dog,  in  other  words,  the  excitement 
of  a  keen  desire  for  it,  is  sufficient  to  cause  a 
flow  of  gastric  juice  from  the  empty  stomach. 
We  shall  presently  have  occasion  to  observe 
the  force  of  this  physiological  factor.  Here  I 
bring  before  you  another  dog,  likewise  having 
a  gastric  fistula  with  divided  oesophagus.  The 
stomach  has  been  washed  out  half  an  hour  ago, 
and  since  then  not  a  drop  of  gastric  juice  has 
escaped.  We  begin  to  get  ready  a  meal  of  flesh 
and  sausage  before  the  animal  as  if  we  meant  to 
feed  it.  We  take  the  pieces  of  flesh  from  one 
place,  chop  them  up,  and  lay  them  in  another, 
passing  them  in  front  of  the  dog's  nose,  and  so 
on.  The  animal,  as  you  see,  manifests  the  live- 
liest interest  in  our  proceedings,  stretches  and 
distends  itself,  endeavours  to  get  out  of  its  cage 
and  come  to  the  food,  chatters  its  teeth  together, 
swallows  saliva,  and  so  on.  Precisely  five  min- 
utes after  we  began  to  tease  the  animal  in  this 
way  the  first  drops  of  gastric  juice  appear  in 
the  fistula  The  secretion  grows  ever  stronger 
and  stronger,  till  it  flows  in  a  considerable 
[  202  ] 


The  A,B,-Z,  of  Our  Own  Nutrition 

stream.  After  the  lapse  of  a  few  minutes  we 
can  count  the  number  of  cubic  centimetres  by- 
tens.  The  meaning  of  this  experiment  is  so 
clear  as  to  require  no  explanation ;  the  passion- 
ate longing  for  food,  and  this  alone,  has  called 
forth  under  our  eyes  a  most  intense  activity  of 
the  gastric  glands.  If  the  experiment  be  fre- 
quently repeated,  one  can  easily  observe  that 
the  keener  and  more  eager  the  desire  on  the 
part  of  the  dog  for  the  food,  the  more  certain 
and  intense  is  the  secretory  effect.  In  extreme 
cases  there  is  even  a  quantitative  relationship 
between  this  effect  and  that  of  the  sham  feeding. 
Here  is  an  experiment  of  Professor  Ssanozki, 
in  which  the  secretory  effect  of  the  mere  tempt- 
ing of  the  animal  with  the  sight  of  food  is  com- 
pared with  that  of  sham  feeding.  A  few  threads 
of  alkaline  mucus  had  just  escaped  from  the 
stomach,  and  then  the  excitation  of  the  dog 
with  flesh  was  begun.  After  six  minutes  the 
secretion  commenced  and  continued  as  follows: 

Duration  of  the  flow.  Quantity  of  the  juice. 

8  minutes lo  c.c 

4       " lo    " 

4       "  10    " 

lO  "  lO     " 

lO  "  lO     ** 

8       "         lo  " 

8       "         lo  " 

19       "         10  " 

19      "         3  " 

[203] 


The  A, B,'  Z,  of  Our  Own  Nutrition 
Then  followed  a  sham  feeding  for  six  minutes. 

Duration  of  the  flow.  Quantity  of  the  juice. 

17  minutes 10  cc. 

9       "  10    " 

8       «         10    " 

It  is  clear  that  in  this  case  the  tempting, 
instead  of  being  less  effective  than  the  sham 
feeding,  on  the  contrary  excelled  it. 

Consequently,  the  observation  of  Bidder  and 
Schmidt  was  perfectly  correct.  It  cannot,  how- 
ever, be  said  that  it  received  general  recognition 
in  physiology,  or  that  it  was  sufficiently  appre- 
ciated. There  are  authors  who  could  never 
convince  themselves  of  its  reality,  and  in  many 
physiological  text-books  it  is  not  once  men- 
tioned. By  way  of  explanation,  we  shall  now 
consider  how  this  matter  must  be  dealt  with  by 
those  who  wish  to  observe  the  effect.  It  is  only 
under  certain  conditions  that  it  can  be  seen. 
Firstly,  the  animal  must  be  healthy  and  vigor- 
ous ;  it  must  have  a  perfectly  uninjured  gastric 
mucous  membrane ;  and  this,  from  the  descrip- 
tion in  the  case  of  many  authors  who  obtained 
a  negative  result,  was  not  the  case.  Secondly, 
the  success  of  the  experiment,  as  stated  above, 
is  dependent  upon  the  intensity  of  the  desire 
for  eating,  and  this,  again,  is  dependent  upon 
how  freely  and  how  long  beforehand  the  dog 
had  eaten,  and  also  upon  what  it  is  tempted 
[  204] 


T^he  A,  B,-Z,of  Our  Own  Nutrition 

with,  whether  with  a  dish  that  excites  its  desire 
or  leaves  its  interest  unawakened.  It  is  known 
that  dogs  have  very  different  tastes,  just  as  men 
have.  Thirdly,  one  may  find  among  the  dogs 
positively  careless,  indifferent  creatures,  incap- 
able of  being  perturbed  in  this  way  by  anything 
which  has  not  actually  reached  their  mouths, 
and  patiently  waiting  till  the  food  is  given  them. 
Hence  for  success  in  the  experiment,  eager, 
impressionable,  and  excitable  animals  are  neces- 
sary. Fourthly,  one  has  to  reckon  with  the 
sense  and  cunning  of  the  dog,  a  factor  which  is 
not  lightly  to  be  disregarded.  Often  the  ani- 
mals perceive  at  once  that  they  are  only  being 
teased  with  the  food,  become  annoyed  thereat, 
and  turn  away  offended  at  what  is  being  done 
before  them.  We  must,  therefore,  so  arrange 
matters  as  if  the  animals  were  not  going  to  be 
disappointed  but  fed  in  reality.  If  attention 
be  paid  to  these  conditions  the  experiment  of 
"  psychic  excitation  of  the  gastric  secretion,"  as 
we  usually  term  it,  will  be  found  to  be  as  reliable 
as  the  experiment  of  sham  feeding.  When  one 
is  occupied  for  a  length  of  time  with  the  study 
of  the  gastric  secretion  under  different  con- 
ditions, one  becomes  convinced  of  what  a  dan- 
gerous source  of  error  this  psychic  excitability 
may  become  in  the  different  experiments.  We 
must  constantly  fight,  so  to  speak,  against  this 
[205] 


The  A,B,'Z.  of  Our  Own  Nutrition 

factor,  keep  it  ever  in  view,  and  guard  against  it. 
If  the  dog  has  not  eaten  for  a  long  time,  every 
movement,  —  the  going  out  of  the  room,  the  ap- 
pearance of  the  attendant  who  ordinarily  feeds  the 
animal  —  in  a  word,  every  little  triviality  may  give 
rise  to  excitation  of  the  gastric  glands.  The  mi- 
nutest attention  is  necessary  in  order  to  avoid  such 
sources  of  error,  and  we  should  not  be  far  wrong 
if  we  said  that  much  which  has  been  ascribed  in 
former  investigations  to  the  effect  of  this  or  that 
agency  was  in  reaHty  a  result  of  unobserved 
psychic  influence.  Consequently,  in  order  to 
verify  our  own  conclusions  concerning  the  effects 
of  this  or  that  condition,  we  have  performed  many 
of  our  experiments  on  sleeping  animals,  having 
beforehand  convinced  ourselves  by  frequent  repe- 
tition that  sleep  exercises  no  restraining  influence 
on  the  working  of  the  gastric  glands. 

When  we  recall  to  mind  the  failure  of  our 
attempts  to  obtain  a  secretion  of  gastric  juice 
by  any  stimulation  whatever  of  the  buccal  mu- 
cous membrane,  and  at  the  same  time  see  how 
constant  and  intense  the  action  of  this  psychic 
impression  is,  we  are  forced  to  the  inevitable 
conclusion  that  in  our  sham  feeding  experiment 
the  whole  secretory  effect  is  due  to  the  psychic 
stimulus,  that  is  to  say,  to  the  keen  desire  on 
the  part  of  the  animal  for  food  and  the  satis- 
faction of  enjoying  it. 

[206] 


The  A,B,-Z.  of  Our  Own  Nutrition 

In  view  of  the  importance  of  the  act  of  eat- 
ing, which  even  now  is  apparent,  but  which  will 
become  still  more  obvious  when  the  succeeding 
periods  of  secretion  are  investigated,  we  have 
spared  neither  time  nor  trouble  to  arrive  at  a 
correct  explanation  of  the  mechanism  of  this 
factor.  We  have,  therefore,  taken  in  hand  a 
number  of  modifications  of  the  sham  feeding 
experiment,  and  these  investigations  have  con- 
firmed the  opinion  at  which  we  had  arrived. 
If,  for  instance,  the  dog  has  been  prepared  by 
a  long  fast  of  two  to  three  days,  a  very  intense 
secretion  of  gastric  juice  will  always  be  obtained 
by  the  sham  feeding  experiment,  no  matter 
what  may  be  given  it  to  eat,  whether  boiled  or 
raw  flesh,  bread  or  coagulated  egg-white,  etc. 
The  dog,  however,  which  has  not  fasted,  that  is 
to  say  has  been  fed  fifteen  to  twenty  hours  be- 
fore, will  pick  and  choose  amongst  the  different 
foods,  eating  one  with  great  greed,  tolerating  an- 
other, and  refusing  altogether  a  third,  and,  cor- 
responding therewith,  the  amount  and  quality 
of  the  gastric  juice  will  manifest  wide  variations. 
The  more  eagerly  the  dog  eats  the  more  juice 
will  be  secreted  and  the  greater  the  digestive 
power  which  it  possesses.  The  majority  of  dogs 
prefer  flesh  to  bread,  and  correspondingly  less 
juice  will  be  produced  by  sham  feeding  with 
bread  than  with  flesh.  Sometimes,  however, 
[207] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

we  find  dogs  which  will  devour  bread  with 
greater  appetite  than  flesh.  In  these  cases  one 
obtains  more  and  stronger  juice  in  sham  feeding 
with  bread  than  with  flesh.  Here  is  a  case  in 
point:  a  dog  is  given  boiled  meat  which  has 
been  cut  into  pieces  of  definite  size,  and  the 
pieces  follow  each  other  at  regular  intervals  of 
time.  The  animal  eats,  but  soon,  from  its  be- 
haviour, you  see  that  it  develops  no  particular 
greed  for  the  meal,  and  this  observation  is  con- 
firmed by  the  fact  that  after  fifteen  to  twenty 
minutes  it  ceases  taking  the  flesh.  The  secre- 
tion of  juice  has  meanwhile  either  not  begun  at 
all,  or  only  after  a  longer  interval  than  five 
minutes,  and  remains  scanty  to  the  end.  Now 
wait  till  the  secretion  has  stopped  and  give  the 
same  dog  raw  flesh,  either  forthwith  or  next 
day,  in  pieces  of  the  same  size  and  at  the  same 
rate  as  before.  The  raw  meat  tastes  excellently 
to  the  dog;  it  eats  for  hours  at  a  time;  the  se- 
cretion of  gastric  juice  begins  precisely  after  five 
minutes  and  is  very  active.  With  another  dog 
which  prefers  boiled  to  raw  meat  exactly  the 
reverse  occurs.  Broth,  soup,  milk  —  towards 
which  dogs  are  usually  more  indifferent  than 
towards  solid  food  —  often  produce  in  sham 
feeding  either  no  secretion  at  all  or  only  very 
little,  although  broth,  for  instance  has  essen- 
tially the  same  taste  as  flesh. 

[208] 


The  A.  B,-Z.of  Our  Own  Nutrition 

It  is  therefore  clear  that  in  sham  feeding  the 
psychic  effect  may  readily  become  an  absolute 
and  independent  factor.  All  the  conditions 
which  we  enumerated  above,  and  which  are 
necessary  for  the  successful  production  of  the 
psychic  effect,  hold  good  in  combined  form  for 
the  sham  feeding  experiment  The  dog  eats 
with  greed  before  one's  eyes ;  the  food  which  it 
receives  is  pleasant ;  it  not  only  imagines  food 
but  actually  eats  it,  and  has  therefore  no  reason 
to  feel  offended,  for  naturally  the  idea  does  not 
occur  to  any  of  the  dogs  that  all  their  trouble  is 
in  vain. 

Consequently,  in  the  sham  feeding  experi- 
ment, by  the  act  of  eating,  the  excitation  of 
the  nerves  of  the  gastric  glands  depends  upon 
a  psychical  factor  which  has  here  grown  into  a 
physiological  one,  that  is  to  say,  is  just  as  much 
a  matter  of  course,  and  appears  quite  as  regularly 
under  given  conditions  as  any  other  physiologi- 
cal result.  Regarded  from  the  purely  physio- 
logical side,  the  process  may  be  said  to  be  a 
complicated  reflex  act.  Its  complexity  arises 
from  this,  that  the  ultimate  object  is  attained  by 
the  joint  working  of  many  separate  organic 
functions.  The  material  to  be  digested  —  the 
food  —  is  only  found  outside  the  organism  in 
the  surrounding  world.  It  is  acquired  not  alone 
by  the  exercise  of  muscular  force,  but  also 
14  [  209  ] 


T^he  A,  B,-Z,of  Our  Own  Nutrition 

by  the  intervention  of  higher  functions,  such  as 
judgment,  will,  desire.  Hence  the  simultaneous 
excitation  of  the  different  sense  organs,  of  sight, 
of  hearing,  of  smell  and  taste,  is  the  first  and 
strongest  impulse  towards  the  activity  of  the 
gastric  glands.  This  especially  applies  to  the 
two  latter  senses,  since  they  are  only  excited 
when  the  food  has  already  entered  the  organism, 
or  at  least  has  arrived  very  near  it.  It  is  by  the 
establishment  of  this  passionate  desire  for  eating 
that  unerring  and  untiring  nature  has  linked  the 
seeking  and  finding  of  food  with  the  commence- 
ment of  the  work  of  digestion.  That  this  fac- 
tor, which  we  have  now  carefully  analysed, 
stands  in  closest  connection  with  an  every-day 
phenomenon  of  human  life,  namely,  appetite, 
may  easily  be  predicated.  This  agency,  which 
is  so  important  to  life  and  so  full  of  mystery  to 
science,  becomes  here  at  length  incorporated 
into  flesh  and  blood,  transformed  from  a  subjec- 
tive sensation  into  a  concrete  factor  of  the 
physiological  laboratory. 

We  are  therefore  justified  in  saying  that  the 
appetite  is  the  first  and  mightiest  exciter  of  the 
secretory  nerves  of  the  stomach,  a  factor  which 
embodies  in  itself  a  something  capable  of  impel- 
ling the  empty  stomach  of  the  dog  in  the  sham 
feeding  experiment  to  secrete  large  quantities 
of  the  strongest  juice.  A  good  appetite  in  eat- 
[210] 


The  A.B,'  Z.  of  Our  Own  Nutrition 

ing  is  equivalent  from  the  outset  to  a  vigorous 
secretion  of  the  strongest  juice ;  where  there  is 
no  appetite  this  juice  is  also  absent.  To  restore 
appetite  to  a  man  means  to  secure  him  a  large 
stock  of  gastric  juice  wherewith  to  begin  the 
digestion  of  the  meal. 


[211] 


LECTURE  V 

PERIOD  OF  OCCURRENCE  AND  IMPOR- 
TANCE OF  THE  PSYCHIC  OR  APPETITE 
JUICE  IN  THE  SECRETORY  WORK  OF 
THE  STOMACH  — THE  INEFFICIENCY  OF 
MECHANICAL  STIMULATION  OF  THE 
NERVOUS  APPARATUS  OF  THE  GASTRIC 
GLANDS 

The  psychic  secretion  is  the  normal  commencement,  in  the 
majority  of  cases,  of  secretory  activity  on  the  part  of  the 
gastric  glands.  If  the  meal  be  subdivided  and  adminis- 
tered at  intervals,  the  psychic  juice  appears  each  time  — 
Demonstration  of  **  appetite  juice  "  in  a  dog  with  an  iso- 
lated gastric  cul-de-sac.  The  work  of  the  gastric  glands 
if  appetite  juice  be  avoided  by  introducing  food  through 
a  gastric  fistula  unperceived  by  the  animal  —  Digestion  of 
flesh  by  the  stomach  with  and  without  sham  feeding  — 
Duration  of  the  secretory  influence  of  sham  feeding  — 
After  the  cessation  of  the  psychic  effect,  how  is  the  se- 
cretory work  of  the  stomach  maintained  ?  —  Experiments 
to  prove  the  ineffectiveness  of  mechanical  stimulation  : 
excitation  of  the  mucous  membrane  by  means  of  a  glass 
rod,  a  feather,  a  puff  of  sand,  and  by  rhythmic  dilatation 
of  an  india-rubber  ball  —  Contact  between  the  food  and 
the  stomach-wall  may  indirectly  call  the  activity  of  the 
glands  into  play  by  awakening  or  increasing  the  desire 
for  food. 

Gentlemen,  —  On  the  last  occasion  we  made 
ourselves  acquainted  with  the  first  normal  im- 
pulse which,  in  the  natural  course  of  events, 
calls  into  activity  the  innervation  apparatus  of 
[212  ] 


T^he  A.  B,-  Z.  of  Our  Own  Nutrition 

the  gastric  glands.  This  impulse  is  a  mental 
one,  and  consists  in  a  passionate  longing  for 
food,  that  which  in  every-day  hfe,  and  in  the 
practice  of  the  physician,  is  called  "  appetite," 
and  which  everybody,  both  medical  and  lay, 
endeavours  carefully  to  promote.  We  may 
now  venture  to  say  explicitly,  APPETITE  IS 
JUICE,  a  fact  which  at  once  displays  the  pre- 
eminent importance  of  the  sensation.  Medi- 
cal science  endeavours  to  assist  the  debilitated 
stomach  by  introducing  the  active  constituent 
of  gastric  juice  —  pepsin  —  from  without,  or  by 
prescribing  other  remedies  believed  to  promote 
its  secretion.  It  is,  however,  of  interest  to  fol- 
low our  experimental  investigation  still  farther. 
What  position  is  to  be  assigned  to  the  "psychic" 
or  "  appetite-juice  "  ^  in  the  course  of  normal 
gastric  digestion?  Is  any  definite  role  to  be 
attributed  to  it?  What  course  does  gastric 
digestion  take  when  it  is  absent?  Fortunately 
to  all  these  important  questions  satisfactory 
answers  are  forthcoming  by  experiment  We 
have  only  to  regret  that  these  answers  come 
so  late. 

Let  us  recall  to  memory  how  the  secretion 
of  gastric  juice  proceeded  after  feeding  with 
flesh  or  bread  in  the  case  of  our  dog  with  the 

1  One  may  be  permitted  to  use  this  expression  for  the 
sake  of  brevity. 


The  A,B.-  Z.  of  Our  Own  Nutrition 

isolated  miniature  stomach.  The  following  are 
the  quantities  and  digestive  capabilities  of  the 
first  two  hourly  portions  of  juice  after  the  ad- 
ministration of  200  grams  of  flesh  or  bread 
(experiments  by  Dr.  Chigin) : 


Flesh. 

Bread. 

Quantity 
of  juice. 

Digestive 
power. 

Quantity 
of  juice. 

Digestive 
power. 

1st 
2nd 

12.4  C.C. 
13s   " 

5.43  mm. 
3(>3    " 

134  C.C. 

7-4  " 

5.37  mm. 
6.50    " 

You  see  at  once  that  the  secretion  of  the 
first  hour  is  identical  in  the  two  cases  both  as 
regards  quantity  and  digestive  power,  and  only 
in  the  second  is  the  secretory  work  differentiated 
according  to  the  nature  of  the  food.  How  are 
we  to  explain  the  secretion  which  takes  place 
at  the  commencement?  Is  it  not  the  same 
which  we  have  already  seen  in  the  sham  feeding 
experiments?  Is  not  this  first  onrush  of  the 
stream  of  secretion  the  preliminary  psychic 
juice?  Unquestionably,  gentlemen,  this  is  the 
case,  and  we  may  convince  ourselves  of  the  fact 
in  the  most  diverse  ways.  Above  all,  the  fol- 
lowing is  clear :  whatever  occurs  in  the  so-called 
sham  feeding  cannot  wholly  be  absent  in  the 
case  of  normal  feeding,  since  the  former  is 
nothing  else  than  the  isolated  commencement 

[214] 


"The  A.  B,-  Z.of  Our  Own  Nutrition 

of  normal  digestion.  This  justifiable  inference 
is  fully  confirmed,  if  the  secretion  of  the  first 
hours  after  the  administration  of  flesh  and  bread 
be  compared  with  that  after  simple  sham  feed- 
ing. In  the  case  of  feeding  with  flesh  and  bread, 
the  identically  similar  and  high  digestive  power 
of  the  first  hourly  portions  is  striking,  and  this 
power  coincides  with  what  we  have  met  in  sham 
feeding.  Further,  if  the  quantity  of  juice  from 
the  miniature  stomach  during  the  first  hour 
be  compared  with  that  produced  by  the  non- 
resected  part  of  the  organ,  —  to  do  which  we 
must  multiply  it  by  ten,  since  the  resected  cul- 
de-sac  is  approximately  one-tenth  of  the  whole 
organ,  —  it  is  here  again  found  that  the  quantity 
approximately  corresponds  to  the  mean  values 
obtained  by  sham  feeding.  Finally,  the  depres- 
sion in  digestive  power  or  quantity  of  juice 
(with  flesh,  decrease  of  digestive  power;  with 
bread,  decline  in  the  quantity  of  juice),  which 
sets  in  soon  after  the  taking  of  food,  indicates 
that  the  two  conditions  are  connected  with  the 
ingestion  of  food  —  /.  e.,  with  a  transitory  factor 
which  soon  passes  away  and  gives  place  to  other 
conditions.  Our  explanation  becomes  still  more 
convincing  when  we  take  into  consideration  the 
effects  of  other  foods.  If  you  give  the  dog,  for 
example,  something  else  to  eat  which  does  not 
interest  it  to  the  same  degree  as  flesh  or  bread, 
[215] 


T^he  A,  B,-Z.of  Our  Own  Nutrition 

you  will  find  the  initial  increase  in  quantity  and 
strength  of  juice  does  not  appear.  Offer  the 
animal  milk,  for  example,  which  in  sham  feed- 
ing, especially  if  it  does  not  last  long,  calls 
forth,  as  a  rule,  no  secretion,  or  at  all  events 
only  very  little,  and  the  rapid  flow  of  the  com- 
mencement—  the  already-mentioned  initial  rise 
—  absolutely  fails  to  appear.  You  have  already 
seen  the  figures  which  deal  with  this  matter; 
I  think  it  necessary,  however,  to  bring  them 
forward  again  in  order  that  you  may  be  better 
able  to  compare  them  with  the  secretion  after 
flesh  and  bread. 

The  dog  was  given  600  c.c.  of  milk  (ex- 
periment by  Dr.  Chigin). 

Hour.  Quantity  of  juice.  Digestive  power. 

1st      ...      4.2  C.C 3.57  mm. 

2nd    .     .     .     12.4  "    .     .     .     .    2.63    " 

We  have  now  begun  the  analytical  examina- 
tion of  the  variations  of  our  secretory  curve. 
But  owing  to  the  importance  of  the  matter  we 
did  not  confine  ourselves  to  conclusions  which 
might  be  drawn  from  earlier  investigations. 
We  turned  to  new  forms  of  experiment  for 
further  proof. 

Thus  we  divided  the  ordinary  ration  of  flesh 
given  to  our  dogs  —  400  grams  —  into  four  equal 
parts,  which  were  administered  at  intervals  of 
an  hour  and  a  half.     (Experiments  by  Privat 

[216] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

decent  Kotljar  and  Dr.  Lobassoff.)  Each  time 
after  the  dog  received  its  lOO  grams  of  flesh  we 
were  able  to  detect  a  rise  both  in  the  quantity 
and  in  the  digestive  power  of  the  juice.  The 
following  table  shows  the  figures  in  question : 


Halthour 

Quantity 

Digestive 

Remarks. 

periods. 

of  juice. 

power. 

1st 

3.1  C.C. 

5.13  mm. 

100  grms.  flesh  given. 

2nd 

5.0    " 

4.63      " 

3rd 

4.7     " 

4.50     " 

4th 

5-4   " 

4.88     " 

100  grms.     "         " 

5th 

5-5   " 

338      " 

6th 

4.7    " 

2.75 

7th 

6.0   " 

3-75    " 

100  grms.     "         '* 

8th 

5-4   " 

2.50    " 

9th 

5-9   " 

2.50    " 

loth 

5.4   " 

388    " 

icx>  grms.     "         " 

nth 

S-3 

3.0      " 

1 2th 

4.2   " 

2-5        " 

In  the  curve  which  follows,  only  the  varia- 
tions of  digestive  power  are  represented. 

It  is  clear  that  the  increase,  both  of  digestive 
power  and  of  juice  volume,  is  connected  with 
the  act  of  taking  in  food. 

It  appeared  of  interest  definitely  to  determine 
the  volume  and  properties  of  the  secretion 
called  forth  by  the  act  of  eating  in  the  dog  with 
the  isolated  stomach.  We  endeavoured,  there- 
fore, at  the  beginning,  to  imitate  the  conditions 
of  sham  feeding  as  they  occurred  in  the  case  of 
the  dog  with  divided  oesophagus.  In  addition 
to  the  fistular  orifice  leading  into  the  isolated 


HALF-HOURLY   PERIODS 


12345 


9  10  II  12 


The  A,B.-Z,  of  Our  Own  Nutrition 

miniature  stomach,  another  was  opened  into  the 
main  portion  of  the  organ.  If  we  now  fed  the 
dog  in  the  ordinary  way  with  small  pieces  of 
flesh,  these  were  received  back  again  at  the 
orifice  of  the  latter  fistula,  covered  with  saliva. 
Precisely  as  in 
sham  feeding, 
after  five  min- 
utes the  juice 
began  to  flow 
simultaneously, 
from  both  the 
large  and  small 
stomachs.  The 
secretion  ran  a 
corresponding 
course  in  the 
two  cavities  and 
ceased  at  the 
same  length  of 
time  in  both  after  the  administration  of  food  was 
stopped.  Here  is  an  instance  taken  from  such 
an  experiment  performed  by  Dr.  Lobassoff. 

In  five  minutes  the  dog  had  eaten  eighty 
pieces  of  flesh  (weighing  172  grams),  all  of 
which  soon  afterwards  dropped  out  at  the  fistula. 
The  secretion  began  in  both  stomachs  after  the 
lapse  of  seven  minutes  from  the  commencement 
of  the  feeding,  and  proceeded  as  follows : 

[218] 


Figure  i.  —  Curve  of  digestive  power  con- 
structed from  the  foregoing  table. 


The  A,  B.-Z.of  Our  Own  Nutrition 


Miniature  stomach. 

Main  stomach. 

Hour. 

Quantity 
of  juice. 

Digestive 
power. 

Quantity  of 
juice. 

Digestive  power. 

I 

2 
2i 

7.7  C.C. 

4-5    " 
0.6    " 

>  6.25  mm. 

83.2  C.C. 

S8.i    " 

8.5    " 

5-35  mm. 

>  In  consequence  of 
a  mixture  with 
bile  (10-15  C.C.) 
"the  digestive 
power  was  greatly 

,   reduced. 

The  secretion  from  both  cavities  also  came  to 
an  end  at  the  same  time. 

This  experiment  proves  to  us,  first,  that  the 
main  and  miniature  stomachs  work  in  perfectly- 
parallel  manner  with  each  other.  The  begin- 
ning, the  end,  and  the  intermediate  variations  of 
the  secretion  correspond  in  both  cases.  Sec- 
ondly, the  digestive  power  of  the  secretion 
coincides  in  both,  and  is  the  same  which  was 
observed  in  the  so-called  sham  feeding.  It  has 
here  remained  at  the  same  height  till  the  ces- 
sation of  the  secretion,  without  falling  to  the 
lower  value  which  we  observed  from  the  begin- 
ning of  the  second  hour  onwards,  after  normal 
flesh  feeding. 

This  was  also  confirmed  later,  when  we 
performed  an  oesophagotomy  on  the  dog,  and 
carried  out  sham  feeding  in  typical  form.  Here 
[219] 


The  A,B.-Z.  of  Our  Own  Nutrition 

follows  one  of  these  experiments  taken    from 
Dr.  Lobassoff's  article. 

The  first  drop  of  juice  appeared  from  both 
cavities  during  the  sixth  minute  after  commenc- 
ing the  feeding,  which  was  kept  up  for  half  an 
hour.  The  further  course  of  the  secretion  was 
as  follows : 


Hour. 

Miniature  stomach. 

Main  stomach. 

Quantity 
of  juice. 

Digestive 
power. 

Quantity 
of  juice. 

Digestive 
power. 

ISt 
2nd 

3rd 

7.6  C.C. 

47   " 
I.I    " 

13s  Mai) 

5.88  mm. 

575  ;; 

5-5     " 
5.75  (mean) 

68.25  C.C. 

41-5       " 
14.0       " 

5.5  mm. 
5-38  " 

123.75  (total) 

5.5  (mean) 

The  secretion  came  to  an  end  in  both 
stomachs  at  the  same  time. 

The  above  is  represented  in  curves  in  Figs. 
2  and  3,  the  scale  on  which  that  for  the  main 
stomach  is  drawn  being  ten  times  less  than  that 
for  the  small.  As  you  see,  the  progress  of 
secretion  is  identical  in  both. 

The  existence  of  a  fistula  leading  into  the 
large  stomach  affords  us  also  the  possibility  of 
performing  an  experiment  upon  our  dog  which 
is  exactly  the  converse  of  the  sham  feeding 
experiment,  and  which  constitutes  a  real  experi- 
mentum  crucis.  While  in  sham  feeding,  we  had 
[  220  ] 


T^he  A.B.'  Z,  of  Our  Own  Nutrition 


only,  so  to  speak,  the  beginning  of  digestion 
before  us,  we  are  now  able  in  our  cross  experi- 
ment to  start  at  the  continuation  of  this  begin- 
ning. For  this  purpose  it  is  only  necessary  to 
bring  the  food  into  the  stomach  through  the 
fistula,  without  attracting  the  dog's  attention. 
Since  in  this  experiment  it  is  above  all  necessary 


HOURS                                                        HOURS 
I           II          III                                           I           II        III 

o 

-tv 

°°     IT 

R 

6  M-\ 

60    4\ 

« 

if  ' 

\                       1^^ 

3 

,  :t  - 

V                            .0         t       ^ 

-o 

3           i:    ^ 

>^ 

^  i    '■ 

1-               20  J.               V 

g 

t 

^        -f        \ 

§ 

_        -                        c'^ 

Figure  2,  —  Curve  of  secretion 
from  the  miniature  stomach. 


Figure  3.  —  The  same  from 
the  main  stomach  reduced  ten 
times. 


not  to  excite  the  dog's  appetite,  it  is  best  to 
carry  out  the  procedure  on  the  sleeping  animal. 
I  may  add  at  once,  however,  that  the  same 
result  can  be  obtained  on  the  waking  animal, 
only  the  process  must  be  performed  unnoticed, 
and  the  animal's  attention  must  be  diverted  from 
thoughts  of  food. 

The  results  of  this  experiment  are  striking, 

and  do  not  in  any  way  resemble  the  secretion 

after  normal  feeding.     Some  kinds  of  food,  for 

instance  bread  and  coagulated  white  of  the  hen's 

[221] 


7he  A,B,-Z.  of  Our  Own  Nutrition 

^^<g,  when  directly  introduced  into  the  stomach, 
do  not  yield  a  single  drop  of  juice  during  the 
first  hour  or  more  afterwards.  This  holds  good 
both  for  the  small  and  large  stomachs.  When 
a  glass  rod  is  introduced  into  the  food  contained 
in  the  organ  it  remains  dry.  Flesh,  if  introduced 
at  this  stage,  is  able  to  excite  a  secretion,  but 
the  appearance  of  the  juice  is  considerably 
retarded.  It  begins  from  fifteen  to  forty-five 
minutes  after  the  feeding,  instead  of  from  six 
to  ten,  is  under  normal  circumstances  extremely 
scanty  during  the  first  hour  (3  c.c.  to  5  c.c.  in- 
stead of  12  c.c.  to  15  c.c),  and  possesses  a 
very  low  digestive  power. 

Here  is  an  experiment  by  Dr.  Lobassoff : 


400  grms.  of  flesh  were  brought  into  the  stomach. 


Hour. 
1st 
2nd 
3rd 
4th 
5th 
6th 
7th 
8th 
9th 

loth 


Quantity  of  juice. 
37  C.C.     . 
10.6    " 


9.2 

7.0 

5.6 

6.6 
7-5 
5-3 
3-0 
0.2 


Digestive  power. 
.     2.0    mm. 
.     1.63    " 


i-S 


2.25 
2.63 

1.88 

2.0 

50 


The  secretion  began  twenty-five  minutes  after 
introducing  the  food.  I  now  ask  you  to  compare 
the  following  tables : 

[  222  ] 


T^he  A,B.-Z.  of  Our  Own  Nutrition 


•S)n3ani3dx9 

CJ 

2 

- 

- 

OMj  ui  aomf  jo 

rN» 

ro 

o 

o 

ijtureab  iWox 

ci 

r^ 

»>> 

t  . 

s 

CO     S^ 

6 

■* 

~ 

le 

60O 

0°* 

in 

1 

^S 

F^ 

•2  8 

6 

- 

- 

- 

(Tl.X 

r^ 

lO 

VO 

1 

O-o 

r^ 

•^ 

O 

1 

>.: 

s 

3 

§  s 

sl 

£ 

>J-> 

wn 

"^ 

^•§ 

5^ 

r^ 

fO 

ro 

'>•-] 

1? 

°S 

o 

^ 

^ 

SO 

eg 

O 

00 

^ 

O 

E.S 

Co 

m 

t^ 

vd 

to 

4> 

s 

«  . 

s 

■* 

" 

" 

11 

go. 

^ 

VO 

N 

§8 

w> 

ro 

fO 

CO 

•Sj= 

*.s 

^« 

u 

- 

- 

- 

^o 

=  '5 

LT) 

VO 

N 

y^ 

6o 

C>) 

ro 

r^ 

-<*■ 

i 

T3 

•a 

J3 

cfl 

^ 

X 

M 

N 

CO 

-^ 

[  223] 


'The  A,B.'Z.  of  Our  Own  Nutrition 

The  progress  of  juice  secretion  in  the  above 
is  also  represented  in  the  following  curves : 


12341234^123 


2     3     4 


Figures  4-7.  —  A.  Ordinary  curve  of  gastric  secretion  (200  grms. 
flesh).  B.  Curve  from  direct  introduction  of  food  (150  grms. 
flesh).     C.  Sham  feeding  with  same.     D.  Summation  of  B  and  C. 

As  you  see,  the  curve  which  represents  the 
results  of  the  direct  introduction  of  flesh  ascends 
much  more  slowly  and  does  not  attain  anything 
like  the  height  of  that  caused  by  normal  feed- 
ing with  the  same  food.  But  if  the  quantities 
obtained  by  direct  introduction  of  the  flesh  be 
added  to  those  of  sham  feeding,  the  resulting 
curve  is  almost  identical  with  the  normal. 

In  like  manner  the  digestive  power  of  the 
secretion  in  the  foregoing  experiments  can  be 
dealt  with,  and  with  the  same  result.  It  is  a 
good  instance  of  how  a  secretion  curve  can  be 
synthetically  constructed  from  its  constituent 
factors. 

[  224] 


"The  A.  B.-Z,of  Our  Own  Nutrition 

Finally,  I  am  able  to  demonstrate  to  you 
the  following  instructive  experiment.  In  the 
presence  of  some  of  my  listeners,  whom  I  had 
invited  to  attend  an  hour  before  the  lecture,  I 
carried  out  the  following  procedures  on  two  dogs, 
both  of  which  had  ordinary  gastric  fistulae  and 
were,  besides,  oesophagotomised.  Into  the  stom- 
ach of  one,  while  its  attention  was  distracted  by 
patting  and  speaking  kindly  to  it  in  order  to 
avoid  arousing  any  thoughts  of  feeding,  a  defi- 
nite number  of  pieces  of  flesh  were  introduced 
through  the  fistula.  The  morsels  were  threaded 
on  a  string,  the  free  end  of  which  was  fastened 
to  the  fistular  cannula  by  inserting  a  cork.  The 
dog  was  then  brought  into  a  separate  room  and 
left  to  itself  A  like  number  of  pieces  was  intro- 
duced into  the  stomach  of  the  other  dog  in  the 
same  way,  but  during  the  process  a  vigorous 
sham  feeding  was  kept  up,  the  animal  being 
afterwards  left  alone.  Each  dog  received  lOO 
grams  of  flesh.  Since  then  an  hour  and  a  half 
have  elapsed,  and  now  we  may  draw  the  pieces 
of  flesh  out  by  means  of  the  thread  and  weigh 
them.  The  loss  of  weight,  and  consequently  the 
amount  of  flesh  digested,  is  very  diff*erent  in  the 
two  cases.  In  that  of  the  dog  without  sham 
feeding  the  loss  of  weight  amounts  to  merely  6 
grams,  while  the  flesh  withdrawn  from  the  stom- 
ach of  the  other  dog  weighs  only  70  grams,  that 
15  [  225  ] 


T^he  A.B,-  Z,  of  Our  Own  Nutrition 

is  to  say,  was  reduced  by  30  grams.  This,  there- 
fore, represents  the  digestive  value  of  the  pas- 
sage of  food  through  the  mouth,  the  value  of  an 
eager  desire  for  food,  the  value  of  an  appetite. 

I  give  also  a  series  of  figures  obtained  by 
Dr.  Lobassoff  in  analogous  experiments.  Into 
the  dog's  stomach  25  pieces  of  flesh  ( 100  grams) 
v^^ere  brought.  The  flesh  remained  two  hours 
in  the  cavity.  Without  sham  feeding  6.5  per 
cent,  with  eight  minutes'  sham  feeding  3 1 .6  per 
cent,  of  the  quantity  was  digested. 

Again :  the  flesh  remained  an  hour  and  a 
half  in  the  stomach ;  without  sham  feeding  5.6 
per  cent,  with  five  minutes'  sham  feeding  15 
per  cent,  was  digested. 

Once  more:  the  flesh  remained  five  hours 
in  the  stomach;  without  sham  feeding  58  per 
cent,  with  sham  feeding  85  per  cent,  was  di- 
gested, the  balance  of  undigested  food  being  42 
per  cent  in  the  one  case  and  15  per  cent  in  the 
other. 

I  must,  however,  add  that  from  the  nature 
of  this  experiment  it  is  not  well  adapted  for 
class  demonstration,  and  may  often  fail.  On  the 
one  hand,  it  is  not  at  all  easy  to  conceal  the 
introduction  of  the  flesh  from  the  dog;  on 
the  other,  the  unusual  and  distracting  surround- 
ings of  the  animal  often  causes  a  short  period 
of  sham  feeding  to  have  less  effect  than  would 
[226] 


T^he  A,  B.-Z.of  Our  Own  Nutrition 

otherwise  pertain.  In  order  to  avoid  such  fail- 
ures it  is  better  before  an  audience  to  carry 
out  this  experiment  only  on  dogs  accustomed 
to  appear  in  the  lecture  theatre,  and  of  whose 
temperament  the  experimenter  is  well  assured. 

I  hope  you  have  now  been  convinced  of  the 
great  importance  which  is  to  be  attached  to  the 
passage  of  food  through  the  mouth  and  oesopha- 
gus, or,  in  other  words  —  and  this,  according  to 
our  former  experiences,  means  the  same  thing 
—  to  the  eager  desire  for  food.  Without  this 
longing,  without  the  assistance  of  appetite, 
many  forms  of  food-stuffs  which  gain  entry  to 
the  stomach  remain  wholly  devoid  of  gastric 
juice.  Others,  it  is  true,  excite  a  secretion,  but 
the  juice  poured  out  is  scanty  and  weak. 

It  is  only  later,  when  we  have  still  more 
fully  recognised  the  conditions  upon  which  the 
secretory  work  of  the  gastric  glands  depends, 
that  we  shall  be  able  to  grasp  the  meaning  of 
these  facts  in  a  more  comprehensive  manner. 
For  instance,  why  does  bread  brought  unnoticed 
into  the  stomach  of  the  dog  cause  no  secre- 
tion for  hours,  while  flesh  tolerably  soon  (after 
twenty  to  forty  minutes)  provokes  this  act? 
This  will  be  explained  in  the  next  lecture ;  now, 
however,  we  must  consider  other  questions. 

How  long  does  the  after-effect,  the  echo  of 
the  first  impulse  to  the  secretory  nerves  of  the 
[227] 


The  A,B,-Z,  of  Our  Own  Nutrition 

stomach,  continue  to  last?  How  long  does  appe- 
tite juice  continue  to  flow  after  the  normal  act 
of  eating,  which,  especially  in  the  case  of  ani- 
mals, is  not  of  long  duration  ?  We  have  already 
determined  many  times,  not  only  on  our  dog 
with  the  isolated  stomach,  but  also  on  other  ani- 
mals, how  long  the  after-effect  of  sham  feeding 
is  continued. 

Here,  for  example,  is  an  experiment  from 
the  article  of  Professor  Ssanozki  which  deals 
with  the  point.  The  dog  had  a  gastric  fistula 
and  also  an  opening  leading  into  the  oesopha- 
gus. After  a  sham  feeding  of  five  minutes  the 
secretion  began,  and  was  continued  as  follows: 


Time  in  minutes 

Quantity. 

Digestive  power. 

lO     . 

.     .    25.5  c.c.     ...     8.1  mm. 

lO     .      . 

20.0    " 

8.0     " 

lO      .      . 

13.S    " 

6.8    " 

lO      .      . 

II.O     " 

7-5    " 

lO      . 

8.5   - 

.    8.1    " 

lO      .      . 

6.5   " 

9.0    « 

20    .    . 

13.5   " 

7.4    " 

20    .    . 

II.O    " 

7.2    " 

20    .    . 

7.0  " 

7.2    « 

20    .    . 

11.5   "      . 

6.8    " 

20    .    . 

II.O    " 

6.5    " 

30  • 

6.5 « 

7.6    « 

20      .      . 

5-5  " 

7.2    « 

The    effect,   therefore,    even    after   a    short 

period  of  sham  feeding,  stretches  over  a  length 

of  time.     Naturally  the  same  holds  good  for  the 

taking  of  food  in  the  normal  way.     One  must, 

[  228  ] 


T^he  A,B,-  Z.  of  Our  Own  Nutrition 

however,  bear  in  mind  that  in  sham  feeding, 
with  all  the  force  and  reality  of  a  hunger  sen- 
sation not  satisfied,  the  eager  desire  for  food, 
the  effective  agency,  becomes  more  and  more 
accentuated,  and  therefore  the  secretory  in- 
fluence is  prolonged  and  more  powerful.  In 
normal  feeding,  however,  the  quelling  of  the 
longing,  the  feeling  of  satisfaction  which,  as  is 
well  known,  sets  in  long  before  the  termination 
of  the  digestive  period  from  the  mere  filling  and 
distension  of  the  stomach,  must  diminish  the 
desire  for  food,  and,  consequently,  bring  the 
secretory  effect  to  an  end. 

It  is,  therefore,  improbable  that  the  whole 
secretory  process  in  the  stomach,  which,  in  the 
case  of  certain  kinds  and  quantities  of  food, 
lasts  from  ten  to  twelve  hours,  is  dependent  on 
the  factors  which  we  have  up  to  the  present 
investigated.  This  is  all  the  more  obvious  since 
a  sham  feeding  of  five  minutes,  even  under  the 
most  favourable  circumstances,  does  not  call 
forth  a  secretion  for  longer  than  three  to  four 
hours.  We  must,  therefore,  seek  for  other  ex- 
citing agencies  of  the  innervation  apparatus  of 
the  gastric  glands. 

Why  and  wherefore  is  the  secretion  insti- 
tuted by  psychic  influence  maintained?  What 
would  first  occur  to  all  your  minds  is  naturally 
the  immediate  influence  which  the  food  exerts 
[  229] 


The  A.B.'Z,  of  Our  Own  Nutrition 

upon  the  walls  of  the  stomach.  And  this  is 
true,  but  it  does  not  happen  in  the  simple,  direct 
fashion  current  in  the  minds  of  many  physiolo- 
gists and  physicians.  When  I  said  that  bread 
or  boiled  white  of  tggy  introduced  directly  into 
the  stomach,  may  not  for  hours  produce  a  trace 
of  secretion,  probably  many  of  my  hearers  may 
have  asked  themselves  with  natural  astonish- 
ment, "  How,  then,  is  the  effect  of  the  forced 
feeding  of  phthisical  and  insane  patients,  and 
the  artificial  feeding  of  those  with  gastric  fistulae 
(performed  on  account  of  stricture  of  the 
oesophagus)  to  be  explained  ?  "  I  will  introduce 
my  answer  by  a  very  unexpected  pronounce- 
ment relative  to  the  assertion  that  mechanical 
stimulation  of  the  stomach  wall  by  food  consti- 
tutes a  reliable  and  effective  means  of  calling 
forth  the  secretory  work  of  the  glands.  This 
assertion,  which  is  so  categorically  set  forth  in 
many  text-books  of  physiology,  and  which  conse- 
quently has  gained  hold  of  the  mind  of  the  phy- 
sician, is  nothing  else  than  a  sad  misconception 
degenerated  into  a  stubborn  prejudice.  My 
own  statement,  repeated  in  many  published  arti- 
cles, and  at  the  meetings  of  various  medical  so- 
cieties, that  this  dictum  is  only  a  picture  of  the 
imagination,  has  met,  for  the  most  part,  either 
with  an  unbeheving  shake  of  the  head  or  else 
with  a  direct  avowal  that  "  it  cannot  be  so."  J 
[  230] 


"The  A.B.-  Z.  of  Our  Own  Nutrition 

regret  exceedingly  that  these  steadfast  unbeliev- 
ers are  not  here,  so  that  we  might  together 
bring  the  matter  before  the  tribunal  of  fact,  to 
the  demonstration  of  which  we  will  now  proceed. 
To  this  matter  I  attribute  very  great  importance. 
It  is  on  this  ground,  according  to  my  opinion, 
that  the  whole  battle  must  be  fought  out  be- 
tween the  generally  accepted  view  that  every 
agency  is  capable  of  exciting  the  gastric  mu- 
cous membrane  and  the  theory  that  it  is  only 
excitable  by  specific  and  selected  stimuH.  If 
once  the  defenders  of  the  old  opinion  are  driven 
from  their  position  and  obliged  to  admit  the 
inefficiency  of  mechanical  stimulation,  there 
would  be  nothing  further  left  for  them  than  to 
build  up  new  theories  and  search  out  old  facts 
concerning  gland  work  which  have  hitherto  been 
rigidly  kept  in  the  shade.  We  may  take  it  that 
it  is  mainly  because  people  were  so  seized  with 
the  belief  in  the  direct  and  simple  mechanical 
explanation  that  Bidder  and  Schmidt's  experi- 
ment of  the  excitation  of  gastric  secretion  by 
mental  effect  has  been  so  little  taken  into  con- 
sideration, notwithstanding  that  it  appeared  so 
thoroughly  reliable  and  convincing. 

I  will  now  repeat  the  experiment  of  mechani- 
cal stimulation  of  the  gastric  mucous  membrane 
before  you  in  the  well-known,  traditional,  and 
classic  manner.     Here  is  a  dog  with  a  gastric 
[23^  ] 


7he  A,B.'  Z.  of  Our  Own  Nutrition 

fistula  on  which  a  cervical  oesophagotomy  ha3 
in  addition  been  performed.  I  open  the  fistula ; 
as  you  see,  nothing  flows  out  of  the  stomach ; 
it  was  washed  out  clean  with  water  an  hour  ago. 
We  take  the  celebrated  feather  and  also  a  toler- 
ably strong  glass  rod.  Folds  of  blotting-paper 
saturated  with  red  and  blue  tincture  of  litmus 
are  placed  at  hand.  I  now  ask  my  assistant  to 
continuously  move  the  feather  and  glass  rod, 
alternately,  in  all  possible  directions  in  the 
stomach,  changing  from  one  to  the  other  every 
five  minutes.  On  removal  from  the  stomach 
each  is  carefully  dried  with  red  and  blue  blot- 
ting-paper. You  have  all  seen,  gentlemen,  that 
this  procedure  has  now  been  kept  up  for  half  an 
hour.  From  the  fistular  orifice  not  even  a  sin- 
gle drop  has  escaped,  and,  moreover,  the  drops 
of  moisture  on  all  the  pieces  of  red  blotting- 
paper  I  have  been  able  to  hand  to  you  have 
assumed  a  distinct  blue  tinge,  caused  by  the 
moisture  of  the  alkaline  mucous  membrane. 
The  blue  pieces,  however,  have  merely  been 
made  wet  without  altering  their  colour.  Conse- 
quently, with  the  most  thorough  mechanical 
stimulation  of  the  whole  cavity  of  the  stomach, 
we  have  not  been  able  to  find  a  single  spot 
possessing  a  noticeable  acid  reaction.  Where, 
then,  are  the  streams  of  pure  gastric  juice  of 
which  we  read  in  text-books  !  What  objection 
[232] 


"The  A.B,-Z,  of  Our  Own  Nutrition 

can  be  raised  against  the  conclusiveness  of  this 
experiment?  In  my  opinion  only  one:  that  we 
are  dealing  with  a  dog  out  of  health,  whose  gas- 
tric glands  from  some  possible  cause  are  unable 
to  react  normally.  This  single  objection  can 
be  set  aside  before  your  eyes.  After  failing 
with  the  mechanical  stimulation,  we  proceed 
forthwith  to  the  sham  feeding  of  the  same  ani- 
mal. The  dog  takes  the  food  offered  it  with 
keen  appetite,  and  you  see  that,  exactly  five 
minutes  after  beginning  the  feeding,  the  first 
drops  of  juice  appear  from  the  stomach,  followed 
by  others  faster  and  faster.  I  catch  a  couple 
of  drops  on  the  blue  litmus  paper,  and  you  see 
that  they  produce  bright  red  specks  on  the  blue 
sheet.  After  thirty  minutes*  sham  feeding  we 
have  collected  150  c.c.  of  juice,  which,  without 
filtering,  looks  as  clear  and  transparent  as 
water. 

We  cannot,  therefore,  possibly  doubt  that, 
when  the  proper  stimulus  is  used,  the  gastric 
glands  react  to  it  in  a  perfectly  normal  fashion, 
furnishing  a  healthy  gastric  juice.  From  this  it 
irrefutably  follows  that  only  one  explanation  is 
to  be  found  for  the  negative  result  in  the  first 
half  of  our  experiment,  viz.,  that  the  mucous 
membrane  of  the  stomach,  so  far  as  secretory 
activity  goes,  is  perfectly  indifferent  to  mechani- 
cal excitation.     And  yet  this  mechanical  stimu' 


The  A.  B.'Z.of  Our  Own  Nutrition 

lus  is  demonstrated  as  an  exciting  agency  in 
the  physiological  lecture  theatre.  I  venture  to 
think  that  this  lecture  experiment  from  now  on- 
wards will  quit  the  field,  and  give  place  to  the 
one  I  have  just  shown  you.  This  apparently 
simple  experiment  of  mechanical  stimulation 
can,  however,  only  be  successfully  performed 
when  certain  very  obvious  rules  are  followed. 
These,  however,  physiologists  have  not  observed, 
probably  on  account  of  a  preconceived  belief 
in  the  effectiveness  of  the  mechanical  stimulus. 
These  rules  are  two.  First,  it  is  necessary  that 
the  stomach  should  be  clean,  and  that  nothing 
shall  gain  entry  to  it  from  without.  Such  con- 
ditions were  not  formerly  fulfilled.  It  is  true 
the  stomach  was  emptied  by  removing  the 
stopper  from  the  fistular  cannula,  but  it  was  not 
washed  out  till  an  acid  reaction  was  no  longer 
given,  and  consequently  preformed  gastric  juice 
was  left  behind  between  the  folds  of  the  mucous 
membrane.  At  the  same  time  saliva  from  the 
cavity  of  the  mouth  could  gain  entry,  which 
quickly  became  acidified  in  the  incompletely 
emptied  and  imperfectly  washed-out  organ.  It 
is,  therefore,  not  surprising  that  the  glass  tube, 
by  setting  up  contractions  of  the  stomach,  was 
the  means  of  expressing  small  quantities  of 
acid  fluid  from  the  fistula-tube.  (The  relation- 
ship between  mechanical  stimulation  and  the 
[234] 


l^he  A,B.'Z,  of  Our  Own  Nutrition 

motor  functions  of  the  stomach  is  not  to  be  con- 
founded with  what  we  are  here  speaking  of.) 
That  matters  are  as  I  state,  and  that  the  facts 
correspond  to  the  explanation  is  proved  by 
this ;  namely,  that  nobody  till  now  has  obtained 
genuinely  pure  gastric  juice  of  an  acidity 
amounting  to  0.5  or  0.6  per  cent.  It  is  only 
necessary  to  call  to  mind  that  Heidenhain,  when 
determining  the  acidity  of  the  juice  first  ob- 
tained from  the  resected  stomach,  was  placed  in 
no  little  doubt  as  to  whether  his  results  (0.5  to 
0.6)  were  correct,  and  his  assistant  at  the  time 
(Gscheidlen)  was  set  to  verify  the  correctness 
of  his  standard  solutions.  The  acidity  of  the 
"  purest"  juice  known  at  that  time  was  scarcely 
0.3  per  cent.  As  a  further  proof  that  none  of 
the  older  observers  ever  really  obtained  a  secre- 
tion from  mechanical  stimulation  pure  and  sim- 
ple, we  may  adduce  the  fact  that  none  of  them 
made  mention  of  the  constant  and  precise  period 
of  five  minutes'  latency.  To  overlook  this  was 
not  possible  if  a  genuine  excitation  of  the 
glands  had  been  obtained. 

Of  no  less  importance  is  the  second  con- 
dition when  we  wish  to  perform  the  experiment 
of  mechanical  stimulation  in  the  correct  way. 
It  is  very  necessary  that  the  gastric  glands  be 
not  already  in  activity  at  the  beginning  of  the 
experiment,  and  also  that  during  the  experi- 
[235] 


The  A,  B,-Z,of  Our  Own  Nutrition 

ment  no  impulse  comes  into  play,  which  of 
itself,  apart  from  mechanical  excitation,  could 
excite  the  glands  to  secretion.  Nor  have  we 
any  proof  that  observers  formerly  waited  for 
hours  before  commencing  the  experiment  and 
convinced  themselves  that  the  gastric  glands 
had  ceased  working.  On  the  contrary,  we  have 
not  the  slightest  evidence  to  indicate  that  the 
authors  had  attempted  to  guard  against  acci- 
dental psychical  stimulation  of  the  glands  —  a 
matter  which  we  have  seen  is  of  considerable 
difficulty.  And  some  dogs  are  so  easily  excited 
in  this  way  that  it  is  almost  impossible  to  bring 
their  glands  to  rest,  or  at  least  it  is  necessary  to 
wait  for  hours.  The  experimenter  must  strain 
his  whole  attention  to  preserve  such  an  experi- 
ment free  from  objection.  It  is  only  necessary 
that  some  food  be  near  the  dog,  or  that  the 
hands  of  the  attendant  who  has  prepared  the 
food  should  smell  of  it,  or  that  some  other 
similar  circumstance  should  come  into  play, 
and  the  glass  tube,  quite  undeservedly,  will  be 
made  answerable  for  the  excitation  of  the  gastric 
glands.  As  you  have  just  seen,  both  of  our 
conditions  have  been  fulfilled  on  the  dog  before 
you,  and  the  result  of  the  experiment  stands 
in  irreconcilable  contradiction  to  those  of  the 
laboratory  and  lecture  experiment  of  former 
times. 

[236] 


The  A,B.'  Z,  of  Our  Own  Nutrition 

The  importance  of  the  experiment,  which  I 
have  already  dwelt  upon,  justifies  me  in  making 
still  further  demands  upon  your  attention  in 
order  to  show  you  two  modifications  of  it. 
Nobody  has  as  yet  said,  with  regard  to  mechan- 
ical stimulation,  that  in  order  to  obtain  results 
the  mechanical  agency  must  simultaneously  come 
into  contact  with  numerous  points  of  the  inner 
surface  of  the  stomach.  But  in  order  to  meet 
this  possible  objection  I  will  now  show  you  two 
new  modifications.  Again  a  similar  dog  is 
used,  that  is  to  say,  one  on  which  both  gastrot- 
omy  and  oesophagotomy  have  been  performed. 
The  stomach  has  been  washed  out  clean  and  is 
at  present  in  a  state  of  complete  rest.  Into  the 
fistula  I  bring  a  thick  glass  tube  containing  a 
number  of  small  openings  (2  to  3  mm.  diameter) 
at  its  rounded  end.  The  other  end  of  the  tube 
is  connected  with  a  glass  ball  containing  toler- 
ably coarse  sand.  Leading  into  the  ball  is  a 
second  tube,  with  which  an  india-rubber  pump 
can  be  connected  and  a  blast  of  sand  blown 
through.  By  rhythmic  compression  of  the  india- 
rubber  ball  I  inject  sand  with  considerable  force 
into  the  stomach,  and  this  play  is  kept  up  for 
ten  to  fifteen  minutes;  nevertheless,  we  see  no 
trace  of  gastric  juice.  The  sand  falls  out  again 
between  the  side  of  the  cannula  and  the  glass 
tube,  and  it  is  either  dry  or  scarcely  moistened, 
[237] 


^he  A,B,-Z,  of  Our  Own  Nutrition 

but  in  no  case  is  it  able  to  turn  blue  litmus  red. 
And  yet  we  are  here  dealing  with  a  strong  and 
widely  diffused  stimulus.  Look  for  a  moment 
at  the  performance  of  the  bellows  outside  the 
stomach.  From  every  opening  of  the  tube-- 
numbering  considerably  more  than  ten  —  a 
strong  stream  of  sand  is  ejected.  If  you  hold 
your  hand  against  it,  you  feel  quite  distinctly 
that  the  grains  of  sand  strike  with  considerable 
force.  And  now,  when  our  experiment  is  ended, 
we  may  convince  ourselves  by  sham  feeding,  in 
easy  and  unquestionable  fashion,  that  the  inner- 
vation of  the  dog's  stomach  is  perfectly  normal. 
Yet  another  experiment  on  a  similar  dog. 
Into  its  empty  and  resting  stomach  an  india- 
rubber  ball  is  introduced.  This  is  distended  with 
air  by  means  of  a  syringe  till  it  is  as  large  as  a 
child's  head  and  maintained  in  this  condition  for 
a  time,  afterwards  being  allowed  to  collapse. 
The  procedure  is  kept  up  for  ten  to  fifteen 
minutes.  During  this  time  not  a  single  drop  of 
juice  has  appeared  from  the  stomach.  The  sur- 
face of  the  ball  taken  out  of  the  organ  is  every- 
where alkaline.  And  here  also  subsequent  sham 
feeding  shows  that  the  dog  is  in  a  suitable  con- 
dition for  the  experiment.  I  must  add  that  in 
making  this  observation  the  dog  must  not  be 
too  hungry,  that  is  to  say,  must  have  been  fed 
within  ten  to  twelve  hours  before,  otherwise  a 


The  A.B.-  Z,  of  Our  Own  Nutrition 

psychic  excitation  of  the  secretion  can  readily 
be  induced. 

If  one  dispassionately  regards  this  question, 
and  if  any  of  our  methods  for  the  study  of  gas- 
tric secretion  are  reliable,  one  must  be  con- 
vinced step  by  step  in  the  laboratory  of  the 
uselessness  of  mechanical  stimulation.  In  the 
case  of  dogs  with  an  ordinary  gastric  fistula, 
and  failing  some  special  reason,  not  a  drop  of 
gastric  juice  ever  escapes  from  the  stomach 
other  than  during  the  digestive  period.  How 
could  this  be  the  case  if  the  mechanical  stimu- 
lus were  effective,  since  the  inner  rim  of  the 
fistula-tube  is  continuously  in  contact  with  the 
gastric  mucous  membrane?  The  same  holds 
good  for  the  dog  with  resected  stomach.  Dur- 
ing the  experiment  a  glass  or  india-rubber  tube 
is  brought  sufficiently  far  into  the  cul-de-sac  to 
catch  the  juice,  and  yet  not  a  drop  flows  through 
the  tube,  nor  does  its  inner  surface  ever  become 
acid,  so  long  as  true  secretory  conditions  are 
absent.  Moreover,  the  tube  has  tolerably  often 
to  be  taken  out  and  set  right. 

In  the  ordinary  gastric  fistula  in  dogs,  when 
the  operation  has  lasted  a  long  time  —  over  a 
year  —  folds  of  mucous  membrane  are  often 
formed  in  the  neighbourhood  of  its  inner  orifice 
which  completely  close  the  tube.  In  these  cases 
a  long,  thick,  perforated  metal  tube  hais  to  be 
[239] 


The  A,  B.-Z.of  Our  Own  Nutrition 

passed  in  deeply,  and  yet  the  manipulation  of 
itself  never  calls  forth  a  secretion.  Further,  it 
is  a  daily  occurrence  to  find  in  the  stomach  of 
the  dog  thick  rolls  of  hair,  and  yet  their  pres- 
ence in  no  way  hinders  the  arrest  of  the  se- 
cretion, which  occurs  when  digestion  has  ceased. 
Such  an  occurrence  would  have  been  specially 
obvious  in  our  dog  with  the  isolated  stomach, 
since  it  was  bedded  with  sawdust  in  order  to 
guard  against  maceration  of  the  wound  by  juice 
trickling  out.  Very  often  we  found  enormous 
quantities  of  sawdust  in  the  stomach,  as  much 
as  half  a  pound  weight;  obviously  the  dog  had 
licked  the  wound  from  adherent  sawdust,  which 
it  then  swallowed,  together  with  that  sticking 
to  its  nose.  And  yet  these  particles  of  sawdust 
of  themselves,  which  certainly  acted  as  mechani- 
cal stimuli,  never  caused  a  secretion.  It  appears 
to  me  that  this  long  series  of  facts  ought  to 
suffice  to  carry  the  supposition  to  its  grave 
that  by  direct  mechanical  stimulation  one  is 
able  to  set  the  neuro-secretory  apparatus  of  the 
stomach  into  activity. 

And  yet  the  feather  and  the  glass  tube 
continue  the  even  tenor  of  their  ways  to  this 
moment  and  function  in  some  text-books,  yea, 
even  in  articles  which  specially  treat  of  gastric 
secretion  as  exciters  of  the  gastric  glands. 
There  are,  it  is  true,  a  few  physiologists  who 
[240] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

hold  mechanical  stimulation,  in  relation  to  gas- 
tric secretion,  not  to  be  very  effective,  and  give 
it  a  subordinate  position  in  the  series  of  exciting 
agencies,  but  as  yet  I  know  of  no  other  physi- 
ologist who  has  wholly  denied  its  influence,  and 
who  has  not  held  it  possible  to  obtain  at  least 
some  juice  by  it. 

To  conclude  this  lecture,  we  will  take  into 
consideration  a  question  connected  with  the 
matter  we  have  just  discussed.  Since  the  con- 
tact of  food  with  the  gastric  mucous  membrane 
has  no  direct  influence  on  the  secretion,  is  its 
entry  into  the  stomach  devoid  of  all  connection 
with  the  secretory  process? 

It  can  hardly  be  doubted  that,  under  normal 
conditions,  the  stomach  is  the  seat  of  certain 
definite  sensations,  that  is  to  say,  its  surface  has 
a  certain  degree  of  tactile  sensibility.  This  sen- 
sation is,  as  a  rule,  very  weak,  and  the  majority 
of  people  become  accustomed  to  pay  no  heed 
to  it  in  the  normal  course  of  digestion.  They 
obtain  their  sensations  of  general  well-being, 
and  especially  of  satisfaction  from  the  enjoy- 
ment of  food,  without  taking  cognisance  of  the 
factors  contributing  to  them.  The  feeling  of 
general  hunger,  however,  is  referred  solely  to 
the  stomach. 

On  the  other  hand,  all  of  us  have  met  with 
men  who  could  describe  exactly,  and  with  gusto, 
i6  [  241  ] 


T^he  A.  B.-  Z,of  Our  Own  Nutrition 

how  they  were  able  to  follow  a  special  tit-bit, 
or  a  mouthful  of  a  favourite  wine,  the  whole 
way  through  the  oesophagus  down  to  the 
stomach,  especially  when  the  latter  happened 
to  be  empty.  Naturally  the  gourmand,  who 
directs  his  attention  continuously  to  the  act  of 
eating,  can  in  the  end  distinctly  perceive  sen- 
sations, and  even  call  them  up  to  the  conscious- 
ness, which  in  other  people  are  normally 
masked  by  other  sensations  and  impressions. 
We  may  therefore  take  it  that  the  satisfaction 
derived  from  eating  is  caused  not  only  by 
stimulation  of  the  mouth  and  throat,  but  also 
by  impulses  awakened  by  the  passage  of  the 
food  along  the  deeper  portions  of  the  oesopha- 
gus and  by  its  entry  into  the  stomach.  In  other 
words,  food  which  merely  passes  through  the 
mouth  and  throat  produces  less  enjoyment  and 
excites,  therefore,  a  less  feeling  of  appetite  than 
the  food  which  passes  the  whole  way  into  the 
stomach.  The  appetite,  the  eager  craving  after 
food,  is,  indeed,  a  very  complex  sensation,  and 
often  not  merely  the  need  of  the  organism  for 
food  material  is  necessary  for  its  excitement, 
but  also  a  condition  of  thorough  well-being, 
together  with  a  normal  healthy  feeling  in  all 
parts  of  the  digestive  tract.  For  this  reason 
it  is  easy  to  understand  how  patients  who  have 
diseased  sensations  in  these  organs,  and  who 
[  242  ] 


The  A.B,-Z,  of  Our  Own  Nutrition 

have  no  feeling  of  appetite,  no  desire  for  food, 
remember  the  sensations,  whether  consciously 
or  unconsciously,  even  when  they  are  no  longer 
present.  Cases  are  known  to  neuro-patholo- 
gists  where  people  with  gastric  anaesthesia 
suffered  from  this  loss  of  appetite.  Such 
patients  are  no  longer  conscious  of  having 
stomachs,  and  dislike  the  idea  of  eating  because 
the  food,  as  they  express  it,  appears  to  fall  into 
a  strange  empty  sack.  In  this  way  one  can  also 
conceive  how  the  appetite  becomes  lost  in  cases 
of  long-continued  obstruction  of  the  alimentary 
tube.  The  patients  forget  their  stomachs,  and 
in  such  instances  direct  introduction  of  food  into 
the  organ,  after  an  operation,  may  suddenly 
bring  back  the  appetite. 

As  a  further  illustration,  I  may  be  permitted 
to  give  an  instance  from  my  own  personal  ex- 
perience. After  an  illness  with  which  a  tran- 
sient but  high  fever  was  associated,  although 
otherwise  fully  recovered,  I  had  lost  all  desire 
for  food.  There  was  something  curious  in  this 
complete  indifference  towards  eating.  Perfectly 
well,  I  only  differed  from  others  in  that  I  could 
with  ease  abstain  from  all  food.  Fearing  that 
I  should  collapse,  I  resolved  on  the  second  or 
third  day  to  endeavour  to  create  an  appetite  by 
swallowing  a  mouthful  of  wine.  I  felt  it  quite 
distinctly  pass  along  the  oesophagus  into  the 
[243] 


The  A,  B,'Z,of  Our  Own  Nutrition 

stomach,  and  literally  at  that  moment  perceived 
the  onset  of  a  strong  appetite.  This  observation 
teaches  that  the  tactile  sensation  of  the  stomach 
at  the  moment  of  entry  of  food  is  capable  of 
awakening  or  increasing  the  appetite.  It  is 
known  that  withholding  food  from  the  organ- 
ism, or  in  other  words  the  creation  of  a  neces- 
sity for  food,  does  not  lead  immediately,  nor  in 
all  cases,  to  the  production  of  an  appetite,  to  a 
passionate  craving  for  food.  How  often  does 
it  happen  that  the  ordinary  hour  for  a  meal  has 
struck,  and  yet,  owing  to  some  keenly  interesting 
occupation,  not  the  least  desire  for  food  is  felt? 
It  is  known  to  everybody,  indeed  it  has  become 
a  proverb,  that  real  appetite  first  sets  in  with 
eating.  If  this  be  true,  the  initial  impulse  towards 
awakening  an  appetite  may  originate  in  the 
stomach  and  not  in  the  buccal  cavity.  When 
we  spoke  above  of  the  desire  for  food  being  the 
excitant  of  the  secretory  nerves  of  the  stomach, 
we  naturally  meant  the  passionate  and  conscious 
longing  for  food,  that  which  is  called  "appetite," 
and  not  the  latent  need  of  the  organism  for 
nourishment,  the  lack  of  nutrition,  which  has 
not  yet  been  transformed  into  a  concrete  pas- 
sionate desire.  A  good  example  which  enables 
us  to  differentiate  between  these  two  factors  is 
furnished  by  our  dogs  with  sham  feeding.  The 
necessity  for  food  exists  in  such  cases  even 
[  244] 


The  A.B,-Z.  of  Our  Own  Nutrition 

before  the  experiment ;  the  juice,  however,  only 
begins  to  flow  as  soon  as  this  need  has  taken 
the  form  of  a  passionate  longing.  It  is  there- 
fore quite  possible  that  in  the  case  of  some 
dogs,  and  at  a  certain  stage  of  hunger,  the 
touching  of  the  gastric  mucous  membrane  with 
any  object  at  hand,  its  mechanical  excitation, 
its  distension  by  the  food  mass,  may  give  the 
impulse  which  excites  the  appetite,  and  when 
the  appetite  is  awakened  the  juice  flows.  This 
is  possibly  a  third  reason  why,  in  the  old  ex- 
periment, the  mechanical  stimulus  came  to  be 
considered  effective.  Viewed  from  this  point 
it  may,  to  a  certain  degree,  lead  to  a  reconcilia- 
tion between  my  assertion  concerning  the  in- 
efficiency of  the  mechanical  stimulus  and  the 
generally  prevailing  belief.  I  further  also  admit 
that  mechanical  excitation  will  at  times  call  into 
play  the  work  of  the  gastric  glands,  not  how- 
ever directly  by  means  of  a  simple  physiological 
reflex,  but  indirectly,  after  it  has  first  awakened 
and  enlivened  the  idea  of  food  in  the  dog's  con- 
sciousness, and  thereby  called  forth  the  {)assion- 
ate  desire.  I  hope  that  the  foregoing  will  in  no 
way  lead  to  a  confusion  of  ideas  in  your  minds, 
but  will  assist  you  to  an  exact  and  concrete 
analysis  of  the  previous  simple  explanation  of 
the  facts.  This  representation,  which  bears 
more  or  less  of  a  hypothetical  character,  could, 


The  A,  B,-Z.of  Our  Own  Nutrition 

of  course,  be  submitted  to  experimental  proof. 
For  such  it  is  only  necessary  to  compare  the 
influence  which  sham  feeding  exercises  in  an 
oesophagotomised  dog  with  that  in  one  having 
a  simple  gastric  fistula. 


1 246  J 


LECTURE  VIII 

PHYSIOLOGICAL  ACTION  AND  THE  TEACH- 
ING OF  INSTINCT  :  EXPERIENCES  OF 
THE   PHYSICIAN 

It  would  be  desirable,  in  the  interests  of  medicine,  that 
the  methods  described  in  these  lectures  should  be 
employed  in  experimental  investigations  into  the  pa- 
thology and  therapeutics  of  the  digestive  canal  on  the 
lines  laid  down  —  The  fact  that  the  beginning  of  the 
secretory  work  in  the  stomach  depends  upon  a  psychic 
effect  harmonises  with  the  experiences  of  every-day 
life,  namely,  that  food  should  be  eaten  with  attention 
and  relish  —  To  restore  the  appetite  has  from  all  ages 
been  the  endeavour  of  the  physician  —  The  indifference 
of  the  present-day  physician  towards  appetite  —  Probable 
causes  of  this  —  Curative  remedies  based  upon  a  restora- 
tion of  appetite  —  The  therapeutic  effects  of  bitters 
depend  upon  the  excitation  of  appetite  —  The  usages 
of  the  mid-day  meal  are  in  agreement  with  physiological 
requirements  —  Physiological  reasons  for  certain  in- 
stinctive customs  and  empirical  regulations — Importance 
of  an  acid  reaction  of  the  food  —  Dietetics  of  fat  and 
its  therapeutic  application  —  The  peculiar  position  of 
milk  among  food-stuffs  is  based  on  physiological  reasons 
—  Explanation  of  the  curative  effects  of  sodium  bicar- 
bonate and  sodium  chloride  —  The  causes  of  individual 
differences  in  the  work  of  the  digestive  glands  —  Partici- 
pation of  the  inhibitory  nerves  of  secretion  in  the 
production  of  pathological   effects. 

Gentlemen,  —  To-day  we  shall  endeavour  to 

bring  the  previously  communicated    results    of 

[247] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

our  laboratory  investigations  into  reconciliation 
with  the  customs  observed  in  the  ingestion  of 
food,  and  with  the  regulations  prescribed  by  the 
physician  in  disorders  of  the  digestive  apparatus. 
To  bring  our  knowledge  to  full  fruition,  and  so 
secure  for  it  the  most  useful  application,  the 
same  methods  should  be  applied  from  the  same 
standpoint  to  the  experimental  investigation  of 
the  pathology  and  therapeutics  of  the  alimen- 
tary canal.  Nor  should  we  be  likely  to  encounter 
insuperable  difficulties.  Thanks  to  the  advances 
of  bacteriology,  many  of  the  pathological  proc- 
esses can  now  be  experimentally  produced  in 
the  laboratory.  Moreover,  we  would,  in  a  sense, 
have  to  deal  with  external  ailments,  since  our 
present  methods  enable  us  to  obtain  access  to 
any  desired  part  of  the  inner  surface  of  the 
digestive  canal.  In  such  pathological  animals 
the  functional  diseases  of  the  apparatus  could 
be  studied  in  a  precise  and  detailed  manner; 
that  is  to  say,  the  alterations  of  secretory 
activity,  the  properties  of  the  fluids,  and  the 
conditions  under  which  they  appear  could  be 
examined.  On  such  animals  therapeutic  reme- 
dies could  also  be  tested,  the  whole  process  of 
healing  and  the  final  result  experimentally 
observed,  while  the  conditions  of  secretory 
activity  during  every  phase  of  the  healing 
process  could  be  investigated.     It   can   hardly 

[248] 


T^he  A.  B,'  Z,  of  Our  Own  Nutrition 

be  doubted  that  scientific,  that  is  to  say  ideal, 
medicine,  can  only  take  its  proper  position  as 
a  science  when,  in  addition  to  an  Experimental 
Physiology  and  Pathology,  there  has  also  been 
built  up  an  Experimental  Therapeutics.  A 
proof  that  this  is  possible  is  furnished  by  the 
recent  vigorous  strides  made  by  the  science  of 
bacteriology. 

I  have  already  described  one  of  such  patho- 
logical therapeutic  experiments;  namely,  on  the 
dog  whose  vagi  nerves  were  divided  in  the  neck. 
Other  similar  cases  I  can  also  call  to  mind. 
Our  dog  with  the  two  stomadis  suffered  at  one 
time  from  a  slight  and  transitory  gastric  catarrh. 
It  was  then  very  interesting  to  observe  that  the 
pathological  process  (which  we  were  usually 
able  to  wholly  guard  against)  spread  from  the 
large  to  the  small  stomach.  It  manifested  itself 
here  in  an  almost  continuous  slimy  secretion 
of  very  slight  acidity,  but  of  strong  digestive 
power.  At  the  beginning  of  the  ailment,  indeed 
before  it  became  fully  established,  the  psychic 
stimulation  was  remarkably  effective  (that  is  to 
say,  still  furnished  juice  in  appropriate  quantity), 
while  local  excitants  almost  completely  failed. 
One  may  conceive  that  the  deeper  layers  of  the 
mucous  membrane  with  the  gastric  glands  were 
still  healthy,  and  thus  easily  thrown  into  activity 
by  central  impulses,  whilst  the  surface  of  the 
[  249  ] 


The  A,  B,-Z.of  Our  Own  Nutrition 

membrane  with  the  end  apparatus  of  the  cen- 
tripetal nerves  was  already  distinctly  damaged. 
I  mention  these,  which  I  may  call  impressions 
rather  than  precise  observations,  because  I 
wish  to  point  out  what  a  fruitful  field  awaits  the 
investigator  who  wishes  to  study,  with  the  aid 
of  our  present  methods,  the  pathological  condi- 
tions of  the  digestive  organs  and  their  treatment. 
Such  an  investigation  is  all  the  more  desirable 
because  clinical  study  of  the  same  subject 
(notwithstanding  the  zeal  devoted  to  it  during 
the  last  ten  years  and  the  results  derived  there- 
from) has  to  contend  with  serious  difficulties. 
We  must  not  forget  that  the  sound  or  stomach- 
tube,  the  chief  clinical  instrument,  is  more 
uncomfortable  than  the  ordinary  form  of  gastric 
fistula  which  was  previously  practised  on  ani- 
mals, and  yet  the  physiology  of  the  stomach, 
even  with  the  aid  of  the  latter,  made  no  material 
progress  for  many  long  years.  Nor  is  this 
difficult  to  understand.  The  investigator  ob- 
tained through  the  fistula  a  mixture  of  sub- 
stances from  which  it  was  difficult,  or  even  at 
times  impossible,  to  decide  anything. 

Hence  the  exact  scientific  study  of  therapeu- 
tic questions  in  this  region  still  belongs  to  the 
future.  But  this  does  not  exclude  the  prob- 
ability that  the  newer  acquirements  of  physi- 
ology may  fruitfully  influence  tke  work  of  the 
[250] 


T:he  A,  B.-Z.of  Our  Own  Nutrition 

physician.  But  physiology  naturally  can  make 
no  pretence  to  guide  the  field  of  medicine, 
since  the  knowledge  at  its  disposal  is  incomplete 
and  is  much  more  restricted  than  that  of  the 
broad  world  of  clinical  reality.  As  a  recom- 
pense for  this,  however,  physiological  knowledge 
is  often  able  to  explain  the  causation  of  an 
illness  and  the  meaning  of  empirical  curative 
methods.  To  employ  a  remedy  the  mode  of 
action  of  which  is  not  clear  is  quite  a  differ- 
ent thing  from  knowing  precisely  what  we  are 
doing.  In  the  latter  case  the  treatment  of  the 
diseased  organ  will  be  more  effective  because 
it  will  be  better  adapted  to  the  special  needs  of 
the  case.  It  is  thus  that  medicine,  being  daily 
enriched  by  new  physiological  facts,  will  at 
length  grow  into  what  it  ideally  must  become ; 
namely,  the  art  of  repairing  the  damaged 
machinery  of  the  human  body,  based  upon 
exact  knowledge,  or,  in  other  words,  applied 
physiology. 

We  may  now  return  to  our  subject.  If  it 
be  at  all  admitted  that  human  instinct  is  the 
outcome  of  an  every-day  experience,  which  has 
led  to  the  unconscious  adoption  of  the  most 
favourable  conditions  for  life,  it  is  particularly 
so  with  regard  to  the  phenomena  of  digestion. 
The  expression  that  physiology  merely  confirms 
the  precepts  of  instinct  is  justified  here  more 


The  A.  B.-Z,of  Our  Own  Nutrition 

than  anywhere  else.  It  appears  to  me  also 
that,  in  relation  to  the  foregoing  facts,  instinct 
has  often  made  out  a  brilliant  case  when  brought 
before  the  tribunal  of  physiology.  Perhaps  the 
old  and  empirical  requirement,  that  food  should 
be  eaten  with  interest  and  enjoyment,  is  the 
most  imperatively  emphasised  and  strengthened 
of  all.  In  every  land  the  act  of  eating  is  con- 
nected with  certain  customs  designed  to  dis- 
tract from  the  business  of  daily  life.  A  suitable 
time  of  day  is  chosen,  a  company  of  relatives, 
acquaintances,  or  comrades  assemble.  Certain 
preparations  are  carried  out  (in  England  a 
change  of  raiment  is  usually  effected,  and  often 
a  blessing  is  asked  upon  the  meal  by  the  oldest 
of  the  family).  In  the  case  of  the  well-to-do  a 
special  room  for]  meals  is  set  apart,  musical  and 
other  guests  are  invited  to  while  away  the  time 
at  meals  —  in  a  word,  everything  is  directed  to 
take  away  the  thoughts  from  the  cares  of  daily 
life,  and  to  concentrate  them  on  the  repast. 
From  this  point  of  view  it  is  also  plain  why 
heated  discussions  and  serious  readings  are  held 
to  be  unsuitable  during  meal-times.  Probably 
this  also  explains  the  use  of  alcoholic  beverages 
at  meals,  for  alcohol,  even  in  the  lighter  phases 
of  its  action,  induces  a  mild  narcosis,  which  con- 
tributes towards  distraction  from  the  pressing 
burden  of  the  daily  work.  Naturally  this  highly 
[252] 


The  A,  B,'Z,of  Our  Own  Nutrition 

developed  hygiene  of  eating  is  only  found  in  the 
intelligent  and  well-to-do  classes,  first,  because 
here  the  mental  activity  is  more  strained  and 
the  various  questions  of  life  more  burning ;  and 
secondly,  because  here  also  the  food  is  served  in 
greater  quantity  than  is  required  for  the  wants 
of  the  organism.  In  the  case  of  the  poorer 
classes,  where  mental  activity  is  less  highly 
developed,  the  greater  amount  of  muscular 
activity  and  the  constant  lack  of  more  than 
sufficient  nourishment  insure  a  strong  and  lively 
desire  for  food  in  a  normal  manner,  without  re- 
course to  any  special  regulations  or  customs. 
The  same  conditions  explain  why  the  prepara- 
tion of  food  is  so  choice  in  the  case  of  the  upper 
classes  and  so  simple  in  that  of  the  lower. 
Further,  all  the  accessories  of  the  meal,  which 
are  foretastes  of  the  actual  repast,  are  obviously 
designed  to  awaken  the  curiosity  and  interest, 
and  to  augment  the  desire  for  food.  How  often 
do  we  sec  that  a  person  who  begins  his  custom- 
ary meal  with  indifference  afterwards  enjoys  it 
with  obvious  pleasure  when  his  taste  has  been 
awakened  by  something  piquant  or,  as  we  say, 
appetising.  It  was  here  only  necessary  to  %\vt, 
an  impulse  to  the  organs  of  taste,  that  is,  to 
excite  them,  in  order  that  their  activity  might 
be  later  maintained  by  less  powerful  excitants. 
For  a  person  who  /eels  hungry  such  extra  in- 
[253] 


The  A,  B.'Z,of  Our  Own  Nutrition 

ducements  are,  of  course,  not  necessary.  The 
quelling  of  hunger  in  his  case  affords  of  itself 
sufficient  enjoyment.  It  is  not,  therefore,  with- 
out reason  that  it  is  often  said  that  "  Hunger  is 
the  best  sauce."  This  dictum,  however,  is  only 
right  up  to  a  certain  point,  for  some  degree  of 
appetising  taste  is  desired  by  everybody,  even 
by  animals.  Thus,  a  dog  which  has  not  fasted 
for  more  than  some  hours  will  not  eat  every- 
thing with  equal  pleasure  which  dogs  usually 
eat,  but  will  seek  out  the  food  which  it  relishes 
best.  Hence  the  presence  of  a  certain  kind  of 
spice  is  a  general  requirement,  although  natu- 
rally individual  tastes  differ. 

This  short  discussion  as  to  how  different 
people  behave  with  regard  to  the  act  of  eating 
is  of  itself  testimony  that  care  should  ever  be 
taken  to  keep  alive  the  attention  and  interest 
for  food  and  to  promote  enjoyment  of  the 
repast  —  that  is  to  say,  that  care  should  be 
taken  of  the  appetite.  Every  one  knows  that  a 
normal,  useful  food  is  a  food  eaten  with  appe- 
tite, with  perceptible  enjoyment.  Every  other 
form  of  eating,  eating  to  order  or  from  convic- 
tion, soon  becomes  worse  than  useless,  and  the 
instinct  strives  against  it.  One  of  the  most 
frequent  requests  addressed  to  the  physician  is 
to  restore  the  appetite.  Medical  men  of  all 
times  and  of  every  land  have  held  it  to  be  a 
[254] 


T^he  A,  B.-Z.of  Our  Own  Nutrition 

pressing  duty,  after  overcoming  the  fundamental 
illnesses  of  their  patients,  to  pay  special  atten- 
tion to  the  restoration  of  the  appetite.  I  beheve 
that  in  this  they  are  not  only  animated  by  an 
endeavour  to  free  their  patients  from  trouble- 
some symptoms,  but  also  by  the  conviction  that 
the  return  of  appetite  of  itself  will  favour  the 
restitution  of  normal  digestive  conditions.  It 
may  be  said  that  to  the  same  extent  to  which 
the  patient  wishes  back  his  appetite  the  physi- 
cian has  effectively  employed  measures  to  re- 
store it  Hence  we  have  not  a  few  remedies 
which  are  specially  named  "  gastric  tonics," 
and  whose  action  is  to  promote  appetite.  Un- 
fortunately medical  science  has  latterly  deviated 
from  this,  the  correct  treatment  of  the  appetite, 
and  that  which  corresponds  to  the  real  condi- 
tions. If  one  reads  current  text-books  on  dis- 
orders of  digestion,  it  is  remarkable  how  little 
attention  is  paid  to  appetite  as  a  symptom  or  to 
its  special  therapy.  Only  in  a  few  of  them  is 
its  importance  indicated,  and  then  merely  in 
short,  parenthetic  phrases.  On  the  other  hand, 
one  may  meet  statements  in  which  the  physician 
is  recommended  to  adopt  no  special  means  for 
counteracting  so  unimportant  a  subjective  symp- 
tom as  a  bad  appetite !  After  what  I  have  said 
and  demonstrated  to  you  in  these  lectures,  one 
can  only  designate  such  views  as  gross  miscon- 
[255] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

captions.  If  anywhere,  it  is  precisely  here  that 
symptomatic  treatment  is  essential.  When  the 
physician  finds  it  necessary,  in  disorders  of 
digestion,  to  promote  secretory  activity  by 
different  remedies,  this  object  can  most  certainly 
and  completely  be  achieved  by  endeavouring  to 
restore  the  appetite.  We  have  already  seen 
that  no  other  excitant  of  gastric  secretion,  so  far 
as  quantity  and  quality  of  the  juice  are  con- 
cerned, can  compare  with  the  passionate  craving 
for  food. 

To  a  certain  degree  we  can  understand  — 
and  this  contributes  to  an  explanation  of  mat- 
ters —  how  medical  science  of  our  time  has 
come  to  regard  so  lightly  the  loss  of  appetite 
as  a  special  object  for  treatment.  Now,  how- 
ever, the  experimental  method  has  penetrated 
more  and  more  into  medical  science,  with  the 
result  that  many  pathological  factors  and  thera- 
peutic agents  are  judged  of  according  to  whether 
they  hold  good  in  the  laboratory  or  not  —  that 
is  to  say,  they  are  valued  only  in  so  far  as  they 
can  be  verified  by  laboratory  experiments. 
Naturally  we  do  not  doubt  that  a  movement  in 
this  direction  indicates  a  great  advance,  but 
even  here,  as  with  every  undertaking  of  man- 
kind, things  do  not  proceed  without  mistakes 
and  exaggerations.  We  must  not  consider  an 
event  to  be  a  mere  picture  of  the  imagination 
[  256  ] 


l^he  A,B,-Z,  of  Our  Own  Nutrition 

because  it  is  not  realisable  under  given  experi- 
mental conditions.  We  often  do  not  know  all 
the  essential  conditions  for  the  production  of 
the  phenomenon  in  question,  nor  are  we  yet 
able  to  grasp  the  connection  between  all  the 
separate  functions  of  life  as  fully  as  may  be 
desired.  Thus  in  the  clinical  treatment  and 
pathology  of  digestion  assistance  was  sought 
for  in  the  laboratory,  but  nothing  was  there  met 
with  which  had  a  relation  to  appetite,  and  con- 
sequently this  factor  was  overlooked  in  medical 
practice.  As  stated  above,  the  psychic  gastric 
juice  obtained  only  cursory  mention  in  physi- 
ology, and  this  not  even  by  all  authors;  and 
when  it  was  noticed  it  was  related  more  as  a 
curiosity.  Great  importance  was,  on  the  other 
hand,  assigned  to  the  mechanical  stimulus,  the 
efficiency  of  which,  now  that  our  knowledge  is 
more  complete,  has  been  shown  to  be  purely 
imaginary.  Each  of  the  contending  factors  has 
at  length  been  assigned  its  proper  place,  and 
if  clinical  medicine  maintains  her  worthy  desire 
of  following  out  the  experimental  investigation 
of  her  problems,  she  must  in  actual  practice 
accord  to  appetite  its  old  claim  for  consideration 
and  treatment. 

But     notwithstanding    the     indifference    of 
physicians  to  appetite  in  itself,  many  therapeutic 
measures   are   based   on   the  promotion   of  it 
'7  [257I 


T^he  ud.B.-Z.  of  Our  Own  Nutrition 

And  in  this  the  truth  of  empiricism  makes  itself 
irresistibly  felt.  When  the  patient  is  enjoined 
to  eat  sparingly,  or  when  he  is  restrained  from 
eating  at  all  till  the  physician  expressly  permits, 
or  again,  when  he  is  (for  instance,  during  con- 
valescence) removed  from  his  ordinary  sur- 
roundings and  sent  to  an  establishment  where 
the  whole  life,  and  particularly  the  eating,  is 
regulated  according  to  physiological  needs  — 
in  all  these  cases  the  physician  seeks  to  awaken 
appetite,  and  relies  upon  it  as  a  factor  in  the 
cure.  In  the  first  case,  where  the  food  is  pre- 
scribed in  small  portions,  in  addition  to  prevent- 
ing the  overfilling  of  a  weak  stomach,  the 
oft-recurrence  of  appetite  juice,  which  is  so  rich 
in  quantity  and  so  strong  in  digestive  power, 
is  of  great  importance.  I  ask  you  here  to  call 
to  mind  one  of  our  experiments  in  which  food 
was  given  in  small  portions  to  a  dog,  and  thus 
led  to  a  secretion  of  much  stronger  juice  than 
if  the  whole  ration  had  been  eaten  at  once. 
This  was  an  exact  experimental  reproduction 
of  the  customary  treatment  of  a  weak  stomach. 
And  such  a  regulation  of  diet  is  all  the  more 
necessary,  since,  in  the  commonest  disorders 
of  the  stomach,  only  the  surface  layers  of  the 
mucous  membrane  are  affected.  It  may,  con- 
sequently, happen  that  the  sensory  surface  of 
the  stomach,  which  should  take  up  the  stimulus 

[258] 


The  A.  B.-Z,  of  Our  Own  Nutrition 

of  the  chemical  excitant,  is  not  able  to  fulfil  its 
duty,  and  the  period  of  chemical  secretion, 
which  ordinarily  lasts  for  a  long  time,  is  for  the 
most  part  disturbed,  or  even  wholly  absent.  A 
strong  psychic  excitation,  a  keen  feeling  of 
appetite,  may  evoke  the  secretory  impulse 
in  the  central  nervous  system  and  send  it 
unhindered  to  the  glands  which  lie  in  the 
deeper  as  yet  unaffected  layers  of  the  mucous 
membrane. 

An  instance  of  this,  taken  from  the  patho- 
logical material  of  the  laboratory,  I  have  already 
related  at  the  beginning  of  this  lecture.  It  is 
obvious  in  these  cases  that  the  indication  is  to 
promote  digestion  by  exciting  a  flow  of  appetite 
juice,  and  not  to  rely  upon  that  excited  by 
chemical  stimuli.  From  this  point  of  view  the 
meaning  of  removing  a  patient,  the  subject  of 
chronic  weakness  of  the  stomach,  from  his 
customary  surroundings  is  also  plain.  Take, 
for  instance,  a  mentally  overstrained  individual, 
or  a  responsible  official;  how  often  does  it 
happen  that  he  cannot  for  a  moment  distract 
his  thoughts  from  his  daily  work.  He  eats 
without  noticing  it,  or  eats  and  carries  on  his 
work  at  the  same  time.  This  often  happens, 
particularly  in  the  case  of  people  who  live  in 
the  midst  of  the  incessant  turmoil  of  great  cities. 
The  systematic  inattention  to  the  act  of  eating 
[259] 


^he  A.  B,'Z,of  Our  Own  Nutrition 

prepares  the  way  for  digestive  disturbances  in 
the  near  future,  with  all  their  consequences. 
There  is  no  appetite  juice,  no  "  igniting  juice," 
or,  at  most,  very  little.  The  secretory  activity 
comes  slowly  into  play ;  the  food  remains  much 
longer  in  the  digestive  canal  than  is  necessary, 
or  passes,  for  want  of  sufficient  digestive  juices, 
into  a  state  of  decomposition  which  irritates  the 
mucous  membrane  of  the  aHmentary  canal  and 
brings  it  into  a  condition  of  disease.  No 
medicinal  treatment  can  help  such  a  patient 
while  he  remains  surrounded  by  his  old  con- 
ditions. The  fundamental  cause  of  his  illness 
still  continues  in  progress.  There  is  only  one 
course  to  pursue;  namely,  to  take  him  com- 
pletely away,  to  free  him  from  his  occupation, 
to  interrupt  the  interminable  train  of  thought, 
and  to  substitute  for  a  time,  as  his  only  object 
in  life,  the  care  of  his  health,  and  a  regard  for 
what  he  eats.  This  is  attained  by  sending  the 
patient  to  travel,  or  by  placing  him  in  a  hydro- 
pathic establishment.  It  is  the  duty  of  the 
physician  to  regulate  not  only  the  life  of  in- 
dividual patients  according  to  such  rules,  but 
also  to  have  a  care  that  in  wider  circles  of  the 
community  a  due  conception  of  the  importance 
of  eating  should  be  disseminated.  This  is 
particularly  so  with  the  Russian  physician.  It 
is  precisely  in  the  so-called  intelligent  classes 
[260] 


T:he  A,  B,-Z.of  Our  Own  Nutrition 

of  Russians  that  a  proper  conception  of  life 
generally  is  often  found  wanting,  and  where  an 
absolutely  unphysiological  indifference  towards 
eating  often  exists.  More  methodical  nations, 
like  the  English,  have  made  a  species  of  cult 
of  the  art  of  eating.  It  is,  of  course,  degrading 
to  indulge  excessively  and  exclusively  in  culinary 
enjoyments,  but,  on  the  other  hand,  a  lofty  con- 
tempt for  eating  is  also  reprehensible.  As  so 
often  is  the  case,  the  best  course  here  also  lies 
between  the  two  extremes. 

With  the  establishment  of  mental  effect  upon 
the  secretion  of  juice  the  influence  of  condiments 
enters  upon  a  new  phase.  The  conclusion  had 
already  been  empirically  arrived  at  that  it  was 
not  alone  sufficient  for  the  food  to  be  composed 
exclusively  of  nutrient  substances,  but  that  it 
should  also  be  tasty.  Now,  however,  we  know 
why  this  is  so.  For  this  reason  the  physician, 
who  has  often  to  express  an  opinion  upon  the 
suitability  of  the  dietaries  of  different  persons, 
or  even  of  whole  communities,  should  constantly 
bear  in  mind  the  question  of  psychic  secretion ; 
that  is  to  say,  he  should  inquire  after  and  learn 
how  the  food  has  been  eaten,  whether  with  or 
without  enjoyment  But  how  often  do  the 
people  who  have  charge  of  the  commissariat 
pay  attention  solely  to  the  nutritive  value  of  the 
food,  or  place  a  higher  value  on  everything  else 

[261] 


The  A.  B,-Z.  of  Our  Own  Nutrition 

than  taste?  We  must,  further,  in  the  interest 
of  the  public  weal,  direct  attention  especially 
to  the  feeding  of  children.  If  this  or  that  in- 
clination of  the  taste  ultimately  determines  the 
relation  of  grown-up  individuals  towards  food, 
a  matter  with  which  the  commencing  phase  of 
digestion  is  closely  linked,  it  would  seem  un- 
desirable to  habituate  children  solely  to  a  nicety 
and  uniformity  of  gustatory  sensations.  Such 
might  effect  their  capabilities  of  adapting  them- 
selves to  other  conditions  in  after  hfe. 

The  question  of  the  therapeutic  influence  of 
the  so-called  bitters,  it  appears  to  me,  bears  the 
closest  connection  with  that  of  appetite.  After 
a  long  period  of  high  repute  these  substances 
have  been  almost  expelled  from  the  list  of 
pharmaceutic  remedies.  When  tested  in  the 
laboratory,  they  were  unable  to  justify  their  old 
and  valued  reputation ;  when  directly  introduced 
into  the  stomach,  many  of  them  were  unable  to 
produce  a  flow  of  gastric  juice.  Consequently, 
in  the  eyes  of  the  clinician,  they  became  greatly 
discredited,  so  that  many  were  quite  ready  to 
discard  their  use  altogether.  Obviously,  the 
simple  conclusion  was  drawn  that  a  weak  diges- 
tion could  only  be  assisted  by  a  remedy  which 
directly  excites  secretory  activity.  In  this,  how- 
ever, it  was  forgotten  that  the  conditions  of  the 
experiment  possibly  had  not  corresponded  with 
[262  ] 


^he  A,B,-Z.  of  Our  Own  Nutrition 

the  actual  state  of  affairs.  The  whole  question 
of  the  therapeutic  importance  of  the  bitters, 
however,  acquires  a  different  significance  when 
we  link  it  with  another  question,  such,  for 
instance,  as  how  do  bitters  affect  the  appetite? 
It  is  the  universal  opinion  of  the  earlier  and 
later  physicians  that  bitters  increase  the  appe- 
tite, and  if  this  be  so  everything  is  said.  They 
are,  in  consequence,  real  secretory  stimulants, 
since  the  appetite,  as  has  many  times  been 
repeated  in  these  lectures,  is  the  strongest  of 
all  stimuli  to  the  digestive  glands.  It  is,  how- 
ever, not  by  any  means  strange  that  this  had 
not  previously  been  observed  in  the  laboratory. 
The  substances  were  either  introduced  directly 
into  the  stomachs  of  normal  dogs  or  else  in- 
jected into  the  circulation.  But  their  action  is 
chiefly  bound  up  with  their  effect  upon  the  gus- 
tatory nerves,  and  it  was  not,  therefore,  without 
some  reason  that  this  large  group  of  remedies, 
consisting  of  substances  of  the  most  varied  chem- 
ical composition,  were  grouped  together  mainly 
on  account  of  a  certain  bitter  taste  common  to 
them  all.  A  person  who  suffers  from  digestive 
disturbance  has,  moreover,  a  blunted  taste,  a 
certain  degree  of  gustatory  indifference.  The 
ordinary  foods,  which  are  agreeable  to  other 
people,  and  also  to  himself  when  in  health,  now 
appear  tasteless.    They  not  only  arouse  no  desire 

[263] 


The  A.  B.-Z,  of  Our  Own  Nutrition 

for  eating,  but  may  even  cause  a  feeling  of  dis- 
like; there  is  no  sense  of  taste,  or  at  best  a 
perverse  one.  It  is  necessary,  therefore,  that 
the  gustatory  apparatus  should  receive  a  strong 
stimulus  in  order  to  restore  a  normal  sensa- 
tion. As  experience  teaches,  this  object  is 
most  quickly  attained  by  exciting  sharp,  un- 
pleasant, gustatory  impressions,  which  by  con- 
trast awaken  the  idea  of  pleasant  ones.  In  either 
case  there  is  no  longer  indifference,  and  this 
is  the  foundation  upon  which  an  appetite  for 
this  or  that  kind  of  food  may  be  awakened,  and 
here  a  general  physiological  law  is  illustrated. 
The  light  appears  brighter  after  darkness,  a 
sound  louder  after  silence,  the  enjoyment  of 
blithesome  health  more  intense  after  illness, 
and  so  on.  This  explanation  of  the  appetising 
effects  of  bitters  proceeding  from  the  mouth 
does  not  exclude  the  possibility  of  some  such 
similar  influence  coming  also  from  the  stomach. 
As  has  been  already  stated  in  the  fifth  lecture, 
there  is  some  reason  for  believing  that  certain 
impulses  from  the  cavity  of  the  stomach  are 
likewise  necessary  for  the  excitation  of  appetite. 
It  is  possible  that  bitters  not  only  act  directly 
on  the  gustatory  nerves  in  the  mouth,  but  that 
they  also  act  on  the  mucous  membrane  of  the 
stomach  in  such  a  way  that  sensations  are  gen- 
erated which  contribute  to  the  passionate  crav- 
[264] 


"the  A.B,'  Z.  of  Our  Own  Nutrition 

ing  for  food.  As  a  matter  of  fact,  it  has  been 
confirmed  by  many  clinicians  that  after  the 
administration  of  bitters  some  such  special  sen- 
sations do  arise  in  the  stomach.  The  effect  of 
these  remedies  consists,  therefore,  not  merely 
in  the  generation  of  a  simple  reflex,  but  in  the 
production  of  a  certain  psychic  effect,  which 
indirectly  excites  a  physiological  secretory  ac- 
tivity. The  same  probably  applies  to  other 
substances,  such  as  condiments.  In  any  case, 
whether  our  explanation  corresponds  to  the 
actuality  or  not,  the  question  of  the  therapeutic 
effect  of  bitters  is  settled  in  the  affirmative  the 
moment  we  acknowledge  that  these  substances 
awaken  appetite.  The  problem,  therefore,  of 
an  experimental  investigation  of  bitters  consists 
in  establishing  the  fact  that  they  have  an  effect 
upon  the  appetite.  The  question  is  a  difficult 
one,  and  has  not  hitherto  been  attempted  in 
the  laboratory.  It  is  not  sufficient  to  hand  over 
clinical  observations  to  the  laboratory  as  experi- 
mental proofs.  One  must  have,  in  addition,  the 
assurance  that  the  investigation  has  been  cor- 
rectly carried  out;  that  is  to  say,  that  it  dealt 
exactly  with  the  point  under  consideration.  It 
is  interesting  to  observe  that  the  connection 
between  appetite  and  gastric  juice  is  by  many 
physicians,  and  in  many  text-books  of  medicine, 
exactly  reversed.  Thus  it  is  represented  that 
[265] 


The  A,B,-Z,  of  Our  Own  Nutrition 

some  medicinal  remedy  calls  forth  a  secretion 
of  gastric  juice,  and  this,  by  its  presence  in  the 
stomach,  awakens  an  appetite.  Here  we  have 
to  deal  with  a  false  explanation  of  a  true  fact, 
and  that  because  it  was  not  recognised  that  a 
psychic  effect  could  by  any  possibihty  be  a 
powerful  excitant  of  secretory  nerves.  The 
customs  of  the  chief  meal  of  the  day  also  cor- 
respond with  our  physiological  results.  After 
this  or  that  hors  d'oeuvrey  perhaps  also  with  a 
liqueur  of  brandy  (especially  customary  in 
Russia),  both  of  which  are  designed  to  awaken 
the  appetite,  the  repast  proper  begins,  and,  in 
the  majority  of  cases,  with  something  hot,  con- 
sisting mostly  of  meat  broth  {bouillon,  different 
soups,  and  so  on).  After  this  comes  the  really 
nourishing  food  —  meat  of  different  kinds  served 
in  various  ways,  or,  in  the  case  of  poorer  people, 
stews  made  with  vegetables,  and  therefore  rich 
in  carbohydrate  material.  This  sequence  of 
foods,  from  the  standpoint  of  physiology,  is 
quite  rational.  Meat  broth,  as  we  have  already 
seen,  is  an  important  chemical  excitant  of  gastric 
secretion.  An  attempt  is  therefore  made  in  two 
ways  to  secure  a  free  secretion  of  gastric  juice 
to  act  on  the  chief  food  ;  first,  in  the  excitement 
of  the  appetite  juice  by  the  hors  d'oeuvre^  and 
secondly,  in  the  promotion  of  the  flow  by  the 
action  of  the  meat  broth.  It  is  in  this  way  that 
[266] 


The  A,  B.'Z.of  Our  Own  Nutrition 

human  instinct  has  made  provisions  for  the 
digestion  of  the  chief  meal.  A  good  meat 
broth  can  only  be  afforded  by  well-to-do  people, 
and  consequently  with  the  poorer  classes  a  less 
expensive,  and,  indeed,  also  a  less  effective, 
chemical  excitant  is  used  for  awakening  the 
early  secretion.  For  example,  kwas^  serves 
in  this  way  with  the  Russian  population,  while 
in  Germany,  where  the  price  of  meat  is  high, 
different  kinds  of  soups  are  used,  consisting  of 
water  mixed  with  flour,  bread,  etc.  It  is  further 
to  be  borne  in  mind  that  the  quantity  of  the 
digestive  juices  in  general  stands  in  close  con- 
nection with  the  content  of  water  in  the  organ- 
ism. This  has  been  shown  by  the  experiments 
of  Dr.  Walther  for  the  pancreatic  juice,  and  by 
my  own  for  the  gastric  juice.  If  this  sequence 
of  foods,  therefore,  holds  good  for  healthy 
people,  it  must  be  even  more  strictly  adhered 
to  in  pathological  conditions.  Thus,  when  a 
person  has  no  appetite,  or  only  a  weak  one, 
he  has  no  psychic  juice  or  only  very  little ;  con- 
sequently, the  meal  must  in  every  case  be  begun 
with  a  strong  chemical  excitant  —  for  example, 
with   a   solution    of   the    extractives   of   flesh. 

^  Kwas  is  a  favourite  Russian  drink,  prepared  from  water, 
bread  or  meal,  with  malt  and  yeast.  It  contains  a  considerable 
quantity  of  lactic  acid,  some  acetic  acid,  and  other  products 
of  fermentation. 

[367] 


T^he  A.B.-Z.  of  Our  Own  Nutrition 

Otherwise  solid  foods,  particularly  if  they  do 
not  consist  of  meat,  would  remain  long  in  the 
stomach  without  any  digestion  whatever.  It  is, 
therefore,  in  every  way  desirable  to  prescribe 
meat  juice,  strong  broth,  or  meat  extract  to 
people  who  have  no  appetite.  The  same  ap- 
plies also  to  forced  feeding,  for  instance,  of  the 
insane.  It  is  true  that  the  method  of  introduc- 
tion in  this  case  necessarily  secures  the  presence 
of  a  chemical  excitant,  since  the  food  can  only 
be  introduced  in  a  fluid  form.  In  any  case  the 
addition  of  meat  extract  would  be  very  useful. 
If  one  arranged  the  ordinary  fluid  foods  in  de- 
scending order,  according  to  the  influence  of 
the  chemical  excitants,  the  following  would  be 
the  series :  first,  the  preparations  of  the  flesh, 
such  as  meat  juice  and  the  like ;  secondly,  milk ; 
thirdly,  water. 

The  usual  termination  of  the  repast  is  also, 
from  the  physiological  standpoint,  easy  to  be 
understood.  The  chief  meal  is  generally  ended 
with  something  sweet,  and  everybody  knows 
that  sweets  are  pleasant.  The  meaning  of  this 
is  easy  to  guess.  The  repast,  begun  with  pleas- 
ure, consequent  on  the  pressing  need  for  food, 
must  also,  notwithstanding  the  stilling  of  hunger, 
be  terminated  with  an  agreeable  sensation.  At 
the  same  time  the  digestive  canal  must  not  be 
burdened  with  work  at  this  stage ;  it  is  only  the 

[268] 


The  A.B.'Z.  of  Our  Own  Nutrition 

gustatory  nerves  which  should  be  agreeably 
excited.  After  thus  dealing  in  general  with  the 
usual  arrangement  of  our  meals,  we  may  now 
speak  of  some  special  points. 

Above  all  comes  the  acid  reaction  of  the 
food.  It  is  apparent  that  acidity  enjoys  a 
special  preference  in  the  human  taste.  We 
use  quite  a  number  of  acid  substances.  Thus, 
for  example,  one  of  the  commonest  seasoning 
substances  is  vinegar,  which  figures  in  a  num- 
ber of  sauces  and  such  like.  Further,  many 
kinds  of  wine  have  a  somewhat  acid  taste.  In 
Russia,  kwas,  especially  in  the  acid  form,  is 
consumed  in  great  quantities.  Moreover,  acid 
fruits  and  green  vegetables  are  used  as  food,  and 
they  are  either  of  themselves  acid,  or  made  so 
in  the  preparation.  In  medicine  this  instinct 
is  likewise  often  made  use  of,  and  acid  solu- 
tions, especially  of  hydrochloric  and  phosphoric 
acids,  are  prescribed  in  digestive  disturbances. 
Finally,  Nature  itself  constantly  endeavours  to 
prepare  lactic  acid  in  the  stomach  in  addition 
to  the  hydrochloric  acid.  The  former  arises 
from  the  food  introduced,  and  is  consequently 
always  present.  These  facts  are  all  physiolog- 
ically comprehensible  when  we  know  that  an 
acid  reaction  is  not  only  necessary  for  an  effi- 
cient action  of  the  peptic  ferment,  but  is  at  the 
same  time  the  strongest  excitant  of  the  pan- 
[269] 


T^he  A.B.-Z.  of  Our  Own  Nutrition 

creatic  gland.  It  is  even  conceivable  that  in 
certain  cases  the  whole  digestion  may  depend 
upon  the  stimulating  properties  of  acids,  since 
the  pancreatic  juice  exerts  a  ferment  action 
upon  all  the  constituents  of  the  food.  In  this 
way  acids  may  either  assist  digestion  in  the 
stomach  where  too  little  gastric  juice  is  pres- 
ent, or  bring  about  vicarious  digestion  by  the 
pancreas  where  it  is  wholly  absent.  It  is 
easy,  therefore,  to  understand  why  the  Russian 
peasant  enjoys  his  kwas  with  bread.  The 
enormous  quantity  of  starch  which  he  con- 
sumes, either  as  bread  or  porridge,  demands 
a  greater  activity  upon  the  part  of  the  pan- 
creatic gland,  and  this  is  directly  brought  about 
by  the  acid.  Further,  in  certain  affections  of 
the  stomach,  associated  with  loss  of  appetite, 
we  make  use  of  acids,  both  from  instinct  as 
well  as  medical  direction,  the  explanation  be- 
ing that  they  excite  an  increased  activity  of 
the  pancreatic  gland,  and  thus  supplement  the 
weak  action  of  the  stomach-  It  appears  to 
me  that  a  knowledge  of  the  special  relations 
of  acids  to  the  pancreas  ought  to  be  very  use- 
ful in  medicine,  since  it  brings  the  gland — a 
digestive  organ  at  once  so  powerful  and  so 
difficult  of  access  —  under  the  control  of  the 
physician.  We  could,  for  instance,  intention- 
ally discard  digestion  in  the  stomach,  and  thus 
[270] 


The  A.B.-Z.of  Our  Own  Nutrition 

transfer  it  to  the  bowel,  by  prescribing  sub- 
stances which  do  not  excite  the  gastric  glands. 
On  the  other  hand,  by  lessening  the  acidity  of 
the  gastric  juice  we  could  reduce  the  activity 
of  the  pancreas,  and  these  are  matters  which 
might  be  made  use  of  in  various  special  dis- 
eases, or  even  in  some  general  disturbances 
of  the  digestive  apparatus. 

No  less  instructive  is  a  comparison  of  the 
results  of  our  experiments  upon  fat,  with  the 
demands  of  instinct  and  also  with  the  precepts 
of  dietetics  and  therapeutics.  Everybody  knows 
that  fatty  foods  are  heavy,  that  is,  difficult  of  di- 
gestion, and  in  the  case  of  weak  stomachs  they 
are  usually  avoided.  We  are  now  in  a  position 
to  understand  this  physiologically.  The  exist- 
ence of  fat  in  large  quantities  in  the  chyme 
restrains  in  its  own  interest  the  further  secre- 
tion of  gastric  juice,  and  thus  impedes  the  di- 
gestion of  proteid  substances;  consequently,  a 
combination  of  fat  and  proteid-holding  foods 
is  particularly  difficult  to  digest,  and  can  only 
be  borne  by  those  who  have  good  stomachs 
and  keen  appetites.  The  combination  of  bread 
and  butter  is  less  difficult,  as  might  a  priori  be 
inferred  from  its  wide  employment.  Bread  re- 
quires for  itself,  especially  when  calculated  per 
unit,  but  little  gastric  juice  and  but  little  acid, 
while  the  fat  which  excites  the  pancreatic  gland 
[271  ] 


The  A.  B.'Z.of  Our  Own  Nutrition 

insures  a  rich  production  of  ferment  both  for 
itself  and  also  for  the  starch  and  proteid  of 
bread.  Fat  alone  does  not  count  by  any  means 
as  a  heavy  food,  as  may  be  seen  from  the  fact 
that  large  quantities  of  lard  are  consumed  in 
certain  districts  of  Russia  with  impunity.  This 
also  is  comprehensible,  since  the  inhibitory  in- 
fluence of  the  fat  in  this  case  does  not  prevent 
the  digestion  of  any  other  food-stuff,  and  is 
conducive  to  the  assimilation  of  the  fat  itself. 
There  is  no  struggle  in  this  case  between  the 
several  food  constituents,  and  therefore  no  one 
of  them  suffers.  In  harmony  also  with  daily 
experience  the  physician,  in  cases  of  weakness 
of  the  stomach,  totally  excludes  fatty  food  and 
recommends  meat  of  a  fat-free  kind  ;  for  exam- 
ple, game,  etc.  In  pathological  cases,  however, 
where  an  excessive  activity  of  the  gastric  glands 
is  manifested,  fatty  food,  or  fat  as  emulsion,  is 
prescribed.  And  here  medicine  has  empiri- 
cally brought  to  its  aid  the  restraining  action 
of  fat,  which  we  have  so  strikingly  seen  in  our 
experiments. 

Amongst  all  the  articles  of  human  food,  milk 
takes  a  special  position,  and  this  is  unanimously 
recognised,  both  in  daily  experience  and  in  the 
practice  of  medicine.  By  everybody  milk  is  con- 
sidered a  light  food,  and  is  given  in  cases  of  weak 
digestion  as  well  as  in  a  whole  series  of  severe 
[272] 


The  A,  B.-Z.of  Our  Own  Nutrition 

illnesses ;  for  example,  in  heart  and  kidney  affec- 
tions. The  extreme  importance  of  this  substance, 
a  food  prepared  by  Nature  itself,  we  can  now 
well  understand.  There  are  three  properties  of 
milk  which  secure  it  an  exceptional  position. 
As  we  already  know,  in  comparison  with  nitrog- 
enous equivalents  of  other  foods,  the  weakest 
gastric  juice  and  the  smallest  quantity  of  pan- 
creatic fluid  are  poured  out  on  milk;  con- 
sequently, the  secretory  activity  requisite  for 
its  assimilation  is  much  less  than  with  any  other 
food-stuff.  In  addition,  milk  possesses  a  further 
important  property.  Thus,  when  it  is  intro- 
duced unobserved  into  the  stomach  of  an  animal 
it  causes  a  secretion  both  in  the  stomach  and 
also  one  from  the  pancreas;  consequently,  it 
appears  to  be  an  independent  chemical  excitant 
of  the  digestive  canal ;  and  in  this  action  it  is 
remarkable  that  we  perceive  no  essential  dif- 
ference in  the  effect  when  the  milk  is  brought 
unnoticed  into  the  stomach  from  that  which 
occurs  when  it  is  given  to  the  animal  to  lap. 
Although  flesh  is  a  better  chemical  excitant, 
it  is  by  no  means  a  matter  of  indifference  how 
it  gets  into  the  stomach.  It  must,  therefore,  be 
accepted  that  milk  excites  not  only  a  really 
effective,  but  at  the  same  time  a  very  economic, 
secretion,  and  also  that  the  appetite  is  unable 
to  stimulate  this  secretion  into  a  more  active 
i8  [273] 


T^he  A,B.-Z.  of  Our  Own  Nutrition 

or  abundant  flow.  The  secret  of  the  relation 
of  milk  to  the  secretion  of  the  digestive  juices 
can,  unfortunately,  at  present  be  submitted  to 
no  further  analysis  or  investigation.  We  are  at 
liberty,  however,  to  suppose  that  the  fat  on  the 
one  hand  is  of  importance  for  the  inhibition 
of  the  gastric  glands,  and  the  alkalinity  on  the 
other  for  the  restraint  of  the  pancreas.  Thus 
the  gastric  glands  and  the  pancreas,  notwith- 
standing the  presence  of  excitants,  are  main- 
tained by  milk  at  a  certain  but  not  too  high 
degree  of  activity,  a  matter  which  is  in  every 
way  desirable  in  consideration  of  the  easy 
digestibility  of  its  constituents.  Finally,  the 
third  characteristic  which  is  observed  to  belong 
to  milk,  and  which  is  probably  only  an  expres- 
sion of  the  first,  consists  in  the  following.  When 
one  administers  to  an  animal  equivalent  quanti- 
ties of  nitrogen,  in  the  one  case  as  milk,  in  the 
other  as  bread,  and  afterwards  estimates  the 
hourly  output  of  nitrogen  in  the  urine,  it  results 
that  the  increase  during  the  first  seven  to  ten 
hours  after  the  milk  (compared  with  the  excre- 
tion beforehand)  amounts  only  to  from  12  per 
cent  to  15  per  cent  of  the  nitrogen  taken  in, 
while  after  bread  it  amounts  to  50  per  cent. 
If  the  hourly  rate  of  absorption  and  the  extent 
to  which  milk  and  bread  are  respectively  used 
up  be  taken  into  consideration,  it  has  to  be 
[»74] 


The  A,  B,'Z,of  Our  Own  Nutrition 

admitted  that  these  augmentations  of  urinary 
nitrogen  which  appear  soon  after  feeding  must 
be  expressions  of  the  functional  activity  of  the 
digestive  canal  itself,  and  that  this  activity  in 
the  case  of  bread  is  three  or  four  times  greater 
than  in  the  case  of  milk  {Experiments  of  Prof. 
Rjasanzew) ;  consequently,  in  the  case  of  milk 
a  much  larger  fraction  of  its  nitrogen  is  free  to 
be  used  up  by  the  organism  at  large  (irrespective 
of  the  organs  of  digestion)  than  in  that  of  any 
other  kind  of  food.  In  other  words,  the  price 
which  the  organism  pays  for  the  nitrogen  of 
milk,  in  the  form  of  work  on  the  part  of  its 
digestive  apparatus,  is  much  less  than  that  for 
other  foods.  How  admirably,  therefore,  the 
food  prepared  by  Nature  distinguishes  itself 
when  compared  with  all  others ! 

The  facts  just  related  bring  forward  a  new 
aspect  from  which  the  relative  nutritive  values 
of  different  foods  may  be  judged.  The  older 
criteria  must  frankly  make  room  for  the  new  or 
else  be  displaced  by  them.  Experiments  upon 
the  utilisation  of  food-stuffs,  in  which  what  re- 
mains undigested  is  determined  as  well  as  what 
is  absorbed  into  the  body  fluids,  cannot  alone 
be  trusted  to  solve  the  question  in  a  satisfactory 
manner.  Suppose,  for  instance,  that  in  the 
digestion  of  a  given  food  the  alimentary  canal 
has  been  given  a  certain  work  to  perform ;  if  it 
[27s] 


ne  A,  B,-Z.of  Our  Own  Nutrition 

be  in  health  the  work  will  be  accomplished  in 
the  best  possible  manner  —  that  is  to  say,  with 
complete  abstraction  of  everything  nutrient. 
You  will  thus  learn  how  much  nutrient  material 
was  contained  in  the  food,  but  the  question  of 
its  digestibility  remains  as  obscure  as  before. 
In  your  experiment  you  do  not  know  how  great 
an  effort  it  has  cost  the  alimentary  canal  to 
extract  all  the  nourishment  from  the  food.  Nor 
can  artificial  digestion  experiments  settle  the 
question  of  digestibility,  for  experiments  in 
which  food  is  normally  partaken  of  are  quite 
different  from  those  in  the  test-tube,  where  we 
have  to  deal  with  only  one  juice,  and  not  with 
the  interaction  of  different  juices  and  different 
food  constituents.  That  one  must  here,  as  a 
matter  of  fact,  make  a  distinction  is  clear  from 
the  observation  of  Dr.  Walther  in  our  laboratory. 
Fibrin,  which  is  regarded  by  all  as  the  most 
easily  digested  proteid,  proved,  when  compared 
wuth  a  nitrogen  equivalent  of  milk,  to  be  a  much 
stronger  excitant  of  the  pancreas,  although  milk 
contains,  in  addition  to  nitrogenous  substances, 
a  good  deal  of  other  non-nitrogenous  material. 
The  digestibility  and  nutritive  value  of  foods 
must  obviously  be  decided  by  an  estimation 
of  the  real  work  which  they  entail  upon  the 
digestive  apparatus,  both  in  regard  to  the  quan- 
tity and  quality  of  the  juices  poured  out  on   a 

[276] 


The  A,  B.-Z.of  Our  Own  Nutrition 

given  amount  of  nutrient  material.  The  energy 
used  up  in  gland  metabolism  must  be  deducted 
from  that  of  food  taken  in.  The  remainder  will 
then  indicate  the  value  of  the  food  to  the  organ- 
ism ;  that  is  to  say,  will  give  the  amount  available 
for  use  by  all  the  other  organs  exclusive  of  the 
digestive  apparatus.  From  this  point  of  view 
those  materials  must  be  taken  as  less  nourishing 
and  less  digestible  which  are  in  large  part  used 
up  to  make  good  the  expenditure  entailed  by 
their  digestion  on  the  part  of  the  alimentary 
canal ;  that  is  to  say,  those  food-stufifs  are  less 
useful  whose  nutritive  value  little  more  than  cov- 
ers the  cost  of  their  digestion;  consequently, 
it  is  of  great  practical  importance  to  compare 
from  this  aspect  the  same  foods  differently 
prepared  — for  example,  boiled  and  roast  meat, 
hard  and  soft  boiled  eggs,  boiled  and  unboiled 
milk,  etc. 

A  discussion  of  some  further  medical  ques- 
tions may  here  be  taken  up.  The  first  concerns 
the  therapeutic  use  of  the  neutral  and  alkaline 
salts  of  sodium.  In  clinical,  pharmacological, 
and  physiological  text-books  it  is  stated  now,  as 
ever,  that  these  salts  promote  a  flow  of  gastric 
juice.  We  may  look  in  vain,  however,  for  any 
experimental  foundation  to  support  this  doctrine. 
The  experiments  brought  forward  cannot  be  re- 
garded as  conclusive.  When  Blondlot  sprinkled 
[«77] 


The  A.  B,-Z.  of  Our  Own  Nutrition 

sodium  bicarbonate  upon  flesh,  or  Braun  and 
Griitzner  introduced  sodium  chloride  solutions 
directly  into  the  blood,  they  began  with  methods 
either  false  in  themselves  or  far  removed  from 
normal  conditions.  In  this  case,  however,  the 
gaps  in  the  experiment  were  happily  made  good 
by  the  clinician,  for  the  experiment  appeared  to 
be  confirmatory  of  clinical  experience.  That 
sodium  salts  (the  chloride  and  bicarbonate)  are 
useful  in  disorders  of  the  digestive  apparatus 
there  can  be  no  doubt.  How  do  they  act,  how- 
ever? It  appears  to  me  that  here,  as  in  some 
other  cases,  medical  science  has  fallen  into  error. 
When  we  know  that  an  effect  takes  place  it  does 
not  by  any  means  imply  that  we  know  the  mech- 
anism by  which  it  occurs ;  and  although  medi- 
cine is  broad  enough  and  comprehensive  enough 
to  make  free  use  of  empiricism  in  practice,  yet 
it  often  thinks  in  narrow  grooves  when  it  turns  to 
the  explanation  of  facts.  It  frequently  tries  to 
explain  complicated  healing  processes  in  the 
simplest  way,  on  supposed  physiological  data. 
And  this  is  true  in  the  present  case,  which 
affords  an  example  of  prevalent  medical  reason- 
ing; the  alkalies  work  favourably  in  digestive 
disturbances  —  therefore  they  are  succagogues. 
Naturally  the  stomach,  under  the  influence  of 
alkalies,  sometimes  begins  to  secrete  a  greater 
quantity  of  juice.  This  means,  however,  that  it 
[  278  ] 


T^he  A,  5.-  Z.  of  Our  Own  Nutrition 

has  recovered  from  a  disordered  state  and  has 
returned  to  normal  conditions.  Consequently, 
the  effect  is  due  to  the  fact  of  recovery,  and 
not  to  a  direct  influence  of  the  alkalies.  This 
latter,  however,  must  be  specially  proved.  The 
assistance  afforded  by  the  alkalies  to  the  organ- 
ism might  be  capable  of  another  explanation ; 
for  example,  that  which  is  ordinarily  given.  In 
this  case,  however,  I  venture  to  offer  a  reason 
for  the  effects  of  sodium  chloride,  and  of  the 
alkaline  salts  of  sodium,  which  is  exactly  the 
opposite  of  that  generally  accepted.  We  were 
unable  to  convince  ourselves  of  any  succagogue 
influence  on  the  part  of  these  salts.  Indeed, 
both  on  the  stomach  and  pancreas  they  proved 
in  our  hands  to  have  an  inhibitory  effect.  In 
addition  to  the  experiments  which  I  previously 
brought  forward  concerning  the  relation  of  al- 
kalies to  gastric  and  pancreatic  juice,  I  may 
relate  the  following  observation.  A  dog  which 
fortunately  had  survived  the  performance,  one 
after  the  other,  of  a  gastric  fistula,  a  pancreatic 
fistula,  and  an  oesophagotomy,  received  daily 
during  the  course  of  several  weeks  an  addition 
of  soda  to  its  food.  The  animal  enjoyed  good 
health  and  had  an  excellent  appetite.  When 
the  first  sham  feeding  experiment  was  carried 
out,  the  relatively  small  effect  of  this  otherwise 
very  active  juice-exciting  procedure  at  once 
[279] 


"The  A.B,-Z,  of  Our  Own  Nutrition 

struck  us.  At  the  same  time  we  observed  that 
the  pieces  of  flesh  which  fell  from  the  upper  end 
of  the  oesophagus,  contrary  to  the  ordinary  rule, 
were  hardly  at  all  insalivated.  In  this  dog,  there- 
fore, a  greatly  lowered  activity  of  several  diges- 
tive glands  —  viz.,  of  the  gastric,  pancreatic,  and 
saHvary  glands  —  simultaneously  existed.  With 
regard  to  the  salivary  glands  the  circumstance 
was  naturally  submitted  to  closer  investigation. 
I  believe  that  the  inhibitory  influence  of  the  al- 
kalies on  the  digestive  glands,  which  was  here 
proved  experimentally,  may  furnish  a  basis  for 
the  following  representation  of  their  mode  of 
action  in  producing  healing  effects.  Catarrhal 
affections  of  the  stomach  are  characterised  by  an 
incessant  or  very  protracted  secretion  of  sHmy, 
weakly  acid  gastric  juice.  Further,  in  many 
cases  the  affection  begins  with  a  hypersecretion, 
that  is  an  abnormal  excitability,  of  the  secretory 
apparatus  which  makes  itself  evident  in  a  super- 
fluous and  useless  flow.  The  same  must  be 
conceived  to  happen  in  disorders  of  the  pancre- 
atic gland  ;  at  least  such  a  condition  sets  in  after 
operations  performed  for  physiological  purposes. 
It  is,  further,  justifiable  to  suppose  that,  when 
an  affection  is  once  set  up  by  this  or  that  cause, 
it  may  later  maintain  itself  independently;  for 
continuous  activity  has  undoubtedly  a  harmful 
influence  on  the  glands.     The  due  nourishment, 

[280] 


The  A.  B,'Z,of  Our  Own  Nutrition 

and  the  restoration  of  organs  after  activity,  pro- 
ceeds best  during  rest.  In  the  normal  course 
of  events,  after  a  period  of  active  work  follows  a 
pause,  during  which  the  latent  work  of  restora- 
tion is  accomplished.  When,  therefore,  a  remedy- 
effectively  restrains  the  excessive  work  of  a  dis- 
eased organ,  it  may  in  this  way  contribute  to  the 
removal  of  the  pathological  condition,  and  thus 
to  a  restoration  of  the  normal  state.  In  this  con- 
sists, in  my  opinion,  the  healing  effects  of  the 
alkalies.  One  might  draw  a  parallel  between 
the  action  of  these  substances  in  digestive  dis- 
turbances and  that  of  digitalis  in  compensatory 
disturbances  of  the  heart.  An  uncompensated 
heart  beats  rapidly,  and  thereby  only  aggra- 
vates its  condition.  Its  time  of  rest,  that  is  of 
recovery,  of  restitution  of  the  organ,  is  shortened. 
A  vicious  cycle  is  set  up.  The  weak  action  of 
the  heart  lowers  blood  pressure  ;  the  lowering  of 
this  leads  (from  known  physiological  causes)  to 
an  increase  in  the  number  of  beats ;  the  quick- 
ening leads  to  weakening  of  the  organ.  With- 
out doubt  the  digitalis  aids  by  breaking  through 
this  vicious  cycle,  in  that  it  greatly  slows  the 
pulse,  and  thereby  gives  new  power  to  the  heart. 
With  our  explanation  of  the  action  of  the  alkalies 
harmonises  the  further  circumstance  that,  with 
the  use  of  the  salts  in  question,  a  strict  diet  is 
generally  prescribed,  which  means  that  a  certain 

[28,] 


T^he  A,h,-Z,  of  Our  Own  Nutrition 

amount  of  rest  is  secured  for  the  digestive  glands. 
It  is  interesting  that  in  cHnical  investigations 
with  the  stomach-tube,  after  a  period  when  the 
alkalies  were  looked  upon  as  succagogues,  a  new 
phase  has  also  set  in,  mention  being  now  more 
frequently  made  of  a  restraining  effect. 

The  cause  of  the  erroneous  belief  that  alka- 
lies promote  a  flow  of  juice  obviously  lies  in  this, 
that  people  omitted  to  compare  the  effects  of 
the  saline  solutions  with  those  of  like  quantities 
of  water  {Dr.  Chigin), 

The  second  point  which  we  may  consider  is 
the  following.  The  chief  difficulty  of  the  physi- 
cian who  wishes  to  regulate  the  diet  of  patients 
when  they  suffer  from  digestive  disturbances 
consists  in  the  fact  that  idiosyncrasy  plays  a 
very  important  rdle.  In  one  and  the  same  ill- 
ness, different  patients  react  to  the  same  diet 
in  wholly  different  ways.  That  which  is  agree- 
able to  one,  and  is  well  borne  and  useful,  may 
be  rank  poison  to  another.  Consequently,  the 
golden  rule  in  dietetics  is  to  give  no  directions 
with  regard  to  food  till  one  has  made  inquiries 
concerning  the  inclinations  and  habits  of  the 
patient.  What  does  all  this  indicate?  Till  now 
physiology  had  no  experimental  answer  to  the 
question.  But  our  facts,  it  appears  to  me,  con- 
tribute to  a  clearing  up  of  the  situation.  Every 
food  determines  a  certain  amount  of  digestive 
[282] 


T:he  A.B,'  Z,  of  Our  Own  Nutrition 

work,  and  when  a  given  dietary  is  long  contin- 
ued, definite  and  fixed  types  of  glands  are  set  up 
which  can  only  slowly  and  with  difficulty  be 
altered.  In  consequence,  digestive  disturbances 
are  often  instituted  if  a  change  be  suddenly 
made  from  one  dietetic  regime  to  another,  espe- 
cially from  a  sparse  to  a  rich  diet ;  such,  for  in- 
stance, as  happens  after  the  long  Russian  fasts. 
These  disturbances  are  expresssions  of  the  tem- 
porary insufficiency  of  the  digestive  glands  to 
meet  the  new  demands  made  upon  them. 

Finally,  it  may  be  of  some  use  to  relate  the 
following  here.  There  are  often  cases  of  sud- 
den and  unaccountable  digestive  disturbances. 
From  the  standpoint  of  modern  physiology  they 
might  be  explained  by  an  activity  of  the  secreto- 
inhibitory  nervous  system,  which  from  some 
cause  or  other  has  been  excessively  and  abnor- 
mally stimulated.  In  any  case  this  system  is 
now  a  factor  of  which  the  physician  has  to  take 
due  account. 


[«83] 


SWALLOWING    AND    MOVEMENTS    OF 

THE  STOMACH  AND  INTESTINES 

By  W.  B.  Cannon,  M.D. 

Of  the  Physiological  Laboratory  of  the  Harvard  Medical  School 
Boston^  Mass. J  U.S.  A. 

[Note.  —  In  the  beginning  of  1896  Dr.  Professor  Henry 
Pickering  Bowditch,  one  of  our  Board  of  Scientific  Assessors 
in  the  Nutrition  Case  suggested  the  use  of  the  Rontgen  ray 
as  a  means  of  learning  more  than  was  then  known  about  the 
mechanism  of  swallowing.  There  was  much  difference  of 
opinion  among  research  physiologists  about  this  important 
function,  and  the  question  was  far  from  settled.  Magendie 
published  a  theory  of  deglutition,  in  Paris,  in  1836,  which  was 
practically  accepted  until  1876,  when  Dr.  Professor  Angelo 
Mosso,  of  the  University  of  Turin,  Turin,  Italy,  established 
the  theory  of  sole  peristaltic  assistance  in  swallowing.  Again 
in  1880  Dr.  Professor  Kronecker,  of  Berne,  Switzerland,  in 
connection  with  Dr.  Falk,  and  later  in  connection  with  Dr. 
Meltzer,  of  New  York,  produced  evidence  to  prove  a  more 
complicated  process  in  deglutition  than  that  of  peristalsis 
alone.  But  even  Kronecker  and  Meltzer  found,  as  they  went 
on,  evidence  to  modify  their  earlier  beliefs,  and  hence  the  sub- 
ject was  not  cleared  up  to  a  point  of  general  agreement. 

The  suggestion  made  by  Dr.  Bowditch  was  taken  up  in 
the  Harvard  Physiological  Laboratory  and  formed  the  begin- 
ning of  a  series  of  studies  of  the  mechanical  factors  in  diges- 
tion. The  reports  of  these  studies,  presented  by  Dr.  W.  B. 
Cannon  and  collaborators,  in  the  American  fournal  of  Physi- 
ology, in  the  volumes  of  1898  and  1903,  are  so  understandable, 
even  to  the  layman  ignorant  of  physiological  nomenclature, 
that  we  are  prompted  to  give  them,  almost  entire,  leaving  out 
only  the  technical  description  of  the  methods  employed,  which 
are  only  interesting  to  research  students  who  have  access  to 
the  Journal. 

[284] 


The  A,B,'Z.  of  Our  Own  Nutrition 

It  will  be  noted  that  three  of  the  professors  of  physiol- 
ogy mentioned  in  connection  with  this  preliminary  study  of 
the  nutrition  problem  —  Bowditch,  Mosso,  and  Kronecker  — 
are  members  of  our  presently  organised  Board.  —  Horace 
Fletcher.] 


THE   MOVEMENTS   OF  THE   FOOD 
IN   THE   CESOPHAGUS 

By  W.  B.  Cannon  and  A.  Moser 

From  the  Laboratory  of  Physiology  in  the  Harvard  Medical  School 
Extracts  from  American  Journal  of  Physiology,  1898 

The  movements  of  deglutition,  in  common 
with  many  other  physiological  processes,  were 
explained  by  the  older  physiologists  on  ana- 
tomical grounds.  Thus,  Magendie  divided  the 
act  into  three  parts,  corresponding  to  the  ana- 
tomical regions  of  the  mouth,  pharynx,  and 
CESophagus.  The  muscles  of  each  of  these 
divisions  were  considered  the  active  agents  in 
propelling  the  food  onward.  The  function  of 
moving  the  mass  to  the  phar}mx  was  variously 
ascribed  to  the  tongue  itself,  to  the  mylohyoid 
muscles,  and  to  gravity.  For  the  second  part, 
the  movement  through  the  pharynx,  there  was 
more  unanimity  of  opinion,  since  the  constric- 
tors, especially  the  middle  and  lower,  were 
evidently  concerned. 

Direct  observations  on  the  movement  of 
swallowed  masses  in  the  oesophagus  were  first 
made   by    Mosso.     The   oesophagus   of  a  dog 

[285] 


The  A.B.-Z,  of  Our  Own  Nutrition 

was  laid  bare,  and  a  transverse  incision  made 
through  it,  or  a  piece  of  it  excised.  A  small 
wooden  ball  was  placed  in  the  canal  below  the 
excised  part,  and  the  animal  was  then  stimu- 
lated to  swallow.  One  or  two  seconds  after  the 
contraction  of  the  pharyngeal  muscles  a  peri- 
staltic wave  began  to  traverse  the  oesophagus. 
This  wave  did  not  stop  at  the  point  of  excision, 
but  in  due  time  reappeared  below,  and  carried 
the  ball  to  the  stomach.  Thus  the  act  was 
shown  to  be  controlled  by  the  central  nervous 
system.  Peristalsis  was  so  plainly  the  motive 
power  that  the  action  was  never  doubted.  Yet 
this  belief  was  soon  to  be  questioned. 

In  1880  Falk  and  Kronecker  studied  the 
movements  in  the  mouth  and  pharynx,  and  ad- 
vanced the  theory  that  deglutition  was  accom- 
plished by  the  rapid  contraction  of  the  muscles 
of  the  mouth.  During  the  act  of  swallowing  the 
air-tight  buccal  cavity  shows  a  manometric  press- 
ure of  twenty  centimetres  of  water.  The  same 
pressure  was  demonstrated  to  be  present  also  in 
the  oesophagus,  but  not  in  the  stomach.  This 
pressure  was  considered  sufficient  to  force  food 
through  the  oesophagus  before  the  peristaltic 
wave  traversed  it.  Another  argument  for  rapid 
descent  was  found  in  the  fact  that  cold  water 
can  be  felt  in  the  epigastric  region  almost  im- 
mediately after  being  swallowed.  Further,  when 
[286] 


The  A,B,-  Z.  of  Our  Own  Nutrition 

strong  acids  pass  through  the  gullet,  they  cor- 
rode but  small  parts  of  it,  and  not  the  entire 
mucous  membrane,  as  would  be  the  case  were 
the  acid  carried  to  the  stomach  by  peristalsis. 

Over  a  year  and  a  half  ago  it  was  suggested 
by  Prof.  H.  P.  Bowditch  that  if  some  substance 
opaque  to  the  Rontgen  rays  were  swallowed,  it 
could  be  seen  in  its  passage  to  the  stomach,  and 
the  nature  of  its  movement  thus  determined. 
Anaesthesia  could  be  dispensed  with,  —  a  desir- 
able condition,  since  observers  had  found  that 
it  interfered  greatly  with  the  deglutition  reflex. 
It  would  be  unnecessary  to  open  either  the 
abdominal  or  the  pleural  cavity.  The  reflex 
stimulus  of  food,  moreover,  would  be  better 
than  electrical  stimulation  of  the  superior  laryn- 
geal nerve.  In  short,  the  animal  would  swallow 
normal  food  under  practically  normal  condi- 
tions. At  Dr.  Bowditch's  suggestion  and  with 
his  valuable  assistance  —  which  we  gratefully 
acknowledge  —  we  made  the  following  series  of 
experiments. 

To  render  the  swallowed  mass  opaque,  sub- 
nitrate  of  bismuth  was  used.  The  salt  is  tasteless, 
practically  inert,  and  can  be  fed  in  large  quan- 
tities without  harm.  In  order  that  observations 
could  be  made  by  more  than  one  person,  all 
experiments  were  conducted  in  a  dark  room. 
On  the  side  of  the  animal  opposite  the  Crookes 

[287] 


7he  A.B.'Z,  of  Our  Own  Nutrition 

tube  was  placed  an  open  fluorescent  screen,  on 
which  the  different  tissues  of  the  animal  were 
outlined  with  varying  degrees  of  light  and  shade. 
Among  these  shadows  the  swallowed  mass  ap- 
peared as  a  darker  object,  and  thus  its  motion 
could  be  studied. 

For  the  first  experiments  the  goose  was 
selected.  The  head  and  neck  were  held  station- 
ary by  a  tall  pasteboard  collar,  which  allowed 
free  movement  of  the  head  without  constriction 
of  the  neck.  The  fluorescent  screen  was  placed 
against  this  collar  at  a  uniform  distance  of  thirty 
centimetres  from  the  tube.  When  a  bolus  of 
corn-meal  mush  mixed  with  bismuth  was  placed 
in  the  pharynx,  it  descended  slowly  and  regu- 
larly, and  occupied  about  twelve  seconds  in 
passing  over  a  distance  of  fifteen  centimetres. 
The  screen  was  marked  at  intervals  of  two  centi- 
metres with  cross  lines,  by  means  of  which  the 
relative  rate  in  different  parts  of  the  oesophagus 
could  be  studied.  A  vibrator  marking  tenths 
of  a  second  was  interrupted  whenever  the  bolus 
crossed  a  line.  An  average  of  over  one  hun- 
dred such  observations  showed  that  the  rate 
became  slightly  slower  as  the  bolus  proceeded. 

In  order  to  test  liquids,  molasses  was  mixed 

with  bismuth  to  such  a  consistency  as  to  drop 

easily  from  a  glass  rod.    When  this  was  fed  with 

a  pipette,  it  passed  slowly  and  regularly  down 

[288] 


The  A,B.-Z.  of  Our  Own  Nutrition 

the  oesophagus,  clearly  by  peristalsis.  The  rate 
was  about  the  same  as  for  solid  food.  In  both 
these  experiments  the  addition  of  water  would 
sometimes  cause  irregularities  in  the  descent. 
Microscopic  sections  from  four  different  parts 
of  the  oesophagus  of  the  goose  showed  no  histo- 
logical difference. 

In  the  experiments  on  the  cat,  the  animal 
was  placed  on  its  back  and  left  side  on  a  holder. 
The  extremities  were  secured  by  straps.  The. 
head  was  held  between  two  upright  rods,  con- 
nected above  by  a  thong;  this  allowed  free 
movement  of  the  head,  without  resistance  to  the 
passage  of  food.  Shreds  of  meat  dipped  in  bis- 
muth were  ordinarily  masticated  and  swallowed 
without  difficulty.  For  soft  solids,  bread  and 
milk  were  used,  so  fluid  as  to  be  easily  drawn 
up  into  a  pipette.  The  insolubility  of  the  bis- 
muth salt  rendered  the  study  of  liquids  more 
difficult.  Strong  solutions  of  potassic  iodide 
and  other  salts,  and  suspension  of  bismuth,  in 
acacia  and  molasses  were  tried;  but  a  simple 
mixture  of  milk  and  bismuth,  shaken  in  a  test 
tube  and  immediately  drawn  up  into  a  pipette, 
was  found  most  practicable. 

Inasmuch  as  the  movement  of  these  different 

foods  varied  in  different  parts  of  the  oesophagus, 

it  will  be  convenient  to  divide  the  latter  into 

three  sections.      The   first  or  cervical   portion 

19  [  289  ] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

extends  from  the  pharynx  to  the  thorax;  the 
second  or  thoracic,  from  here  to  the  lower  half 
of  the  heart;  and  the  third  comprises  the  rest 
of  the  canal.  The  relative  length  of  these  three 
parts  is  about  in  the  ratio  of  9:8:6. 

The  beginning  of  deglutition  was  noted  by 
one  observer  by  a  finger  on  the  larynx;  the 
same  observer  called  out  when  the  bolus  arrived 
at  the  thorax,  heart,  and  stomach  respectively, 
while  the  other  observer  noted  the  time.  The 
movement  of  solids  will  first  be  considered. 
The  descent  the  entire  way  was  by  peristalsis, 
but  the  rapidity  varied.  The  duration  of  the 
movement  in  the  cervical  portion  was  two  and  a 
half  seconds,  and  in  the  thoracic  region  a  little 
less  than  two  seconds.  At  the  lower  end  of  the 
heart  there  was  sometimes  a  slight  pause.  In 
the  lower  section,  from  the  heart  to  the  stom- 
ach, the  movement  was  decidedly  different ;  the 
rate  was  always  very  slow.  The  distance  was 
less  than  one-third  of  the  entire  canal,  yet  the 
time  consumed  in  this  part  ranged  from  six  to 
seven  seconds,  or  three-fifths  of  the  entire  time 
of  descent.  The  character  of  the  movement 
here  was  also  peculiar.  Whereas  in  the  upper 
sections  the  passage  was  uniform  and  regular, 
with  a  slight  acceleration  in  the  thoracic  region, 
here  it  was  apparently  irregular,  for  the  bolus 
descended  about  one  centimetre  with  each  in- 
[290] 


T:he  A.B.-Z.  of  Our  Own  Nutrition 

spiratory  movement  of  the  diaphragm,  and 
remained  stationary  or  descended  very  sHghtly 
during  expiration.  Thus  a  series  of  hitches 
seemed  to  carry  the  bolus  to  the  cardia.  A 
probable  explanation  of  this  peculiar  movement 
is  that  the  stomach  and  lower  oesophagus  were 
pulled  down  with  each  descent  of  the  diaphragm. 
This  would  make  the  movement  appear  irregu- 
lar, although  it  was  really  a  slow  peristalsis. 
It  may  be  well  to  remark  here  that  this  move- 
ment was  invariably  observed  in  the  cat  with 
every  kind  of  food. 

Semi-solids,  namely,  a  mush  of  bread  and 
milk,  descended  in  the  same  way  as  solids ;  but 
the  rate  was  slightly  faster  in  the  upper  oesopha- 
gus, for  the  bolus  took  about  a  second  less  to 
reach  the  cardiac  level.  From  here  the  rate 
was  the  same  as  with  solids. 

For  liquids,  one  and  a  half  to  two  seconds 
sufficed  for  the  descent  to  the  midheart  region. 
Here  there  often  occurred  a  long  pause,  from 
a  few  seconds  to  a  minute  or  more.  Then  the 
oesophagus  apparently  contracted  above  the 
liquid,  which  slowly  passed  on  to  the  stomach, 
as  already  described.  Sometimes  it  seemed 
as  if  a  swallowing  movement,  evidenced  by  a 
rise  of  the  larynx,  started  the  peristaltic  wave. 
Again,  several  swallows  would  succeed  one  an- 
other before  the  liquid  passed  on.  A  few  times 
[291] 


The  A,B.-Z,  of  Our  Own  Nutrition 

the  bismuth  and  milk  seemed  strung  out  along 
the  CESophagus ;  some  more  liquid  descending 
would  gather  this  up,  and  the  whole  mass, 
assuming  an  ovoid  form,  would  move  into  the 
stomach. 

Thus  in  the  cat  the  total  time  for  degluti- 
tion varies  from  nine  to  twelve  seconds.  The 
lowest  section  presents  no  change  ascribable  to 
a  difference  in  consistency,  while  in  the  upper 
sections  the  rate  does  slightly  increase  with  the 
more  liquid  character  of  the  food. 

In  experiments  on  the  dog,  bismuth  en- 
closed in  capsules  or  wrapped  in  shreds  of  meat 
was  fed  as  the  solid.  The  general  phenomena 
were  as  follows:  With  the  rise  of  the  larynx 
there  was  a  quick,  propulsive  movement  of  the 
bolus,  which  descended  rapidly  for  a  few  centi- 
metres, sometimes  as  far  as  the  clavicle.  From 
this  point  the  rapidity  was  diminished,  yet  no 
pause  was  observed;  the  bolus  simply  moved 
more  slowly.  This  rate  was  then  continued  to 
the  stomach  without  a  slackening  of  speed  in  the 
diaphragmatic  region,  as  was  observed  in  the 
cat.  Semi-solids  moved  in  the  same  way  as 
solids.  The  total  time  of  descent  from  larynx 
to  stomach  was  from  four  to  five  seconds. 

Liquids  gave  even  a  more  decided  squirt  in 
the  beginning  of  the  movement.  To  render  the 
oesophagus  as  lax  and  free  as  possible,  the  head 
[292] 


The  A.B.-Z,  of  Our  Own  Nutrition 

of  the  dog  was  released  from  the  upright  rods 
and  held  by  the  hands  after  the  food  was  placed 
in  the  mouth.  Sometimes  the  liquid  descended 
rather  rapidly  as  far  as  the  heart,  at  other  times 
no  further  than  the  clavicle;  then  without  a 
pause  it  passed  on  slowly  and  regularly,  reach- 
ing the  stomach  in  about  the  same  time  as  solids 
and  semi-solids. 

Thus  in  the  dog  and  cat  but  little  variation 
was  seen  in  the  swallowing  of  liquids  and  solids. 
The  liquids  pass  somewhat  faster  in  the  upper 
CESophagus.  But  in  some  animals  the  difference 
of  rate  with  foods  of  varying  consistency  is  much 
more  marked.  In  the  horse,  for  instance,  mere 
observation  shows  a  decided  variation  in  the  rate 
of  movement  in  the  oesophagus.  Liquids  shoot 
along  the  gullet,  while  solids  move  clearly  by 
peristalsis.  To  determine  the  rate  of  solids,  one 
hand  was  placed  on  the  larynx  of  a  horse  to 
note  the  beginning  of  swallowing,  and  the  other 
hand  near  the  shoulders,  where  the  bolus  could 
be  easily  felt  in  its  passage.  The  time  con- 
sumed by  the  bolus  in  passing  over  a  certain 
distance  was  measured  by  a  stop  watch.  The 
rate  obtained  for  solids,  such  as  hay  or  grain, 
was  from  thirty-five  to  forty  centimetres  a 
second. 

For  semi-solids,  a  mixture  of  bran  and  water 
was  made.,  thin  enough  to  run  easily  between 
[293] 


The  A.B.-  Z.  of  Our  Own  Nutrition 

the  fingers.  Each  bolus  was  watched  by  a 
separate  observer  with  a  separate  watch.  The 
average  rate  obtained  was  the  same  as  for 
solids. 

Liquids  in  the  horse  pass  with  a  rapidity  too 
great  to  be  affected  by  peristalsis.  Another 
force  must  be  sought.  Among  the  various 
muscles  supposed  to  be  effectual  in  moving  food 
into  the  pharynx,  the  mylohyoids  were  shown 
by  Meltzer  to  be  essential.  The  styloglossi 
were  cut  by  him  without  much  interference  with 
deglutition,  but  section  of  the  mylohyoid  nerves 
rendered  the  act  impossible.  The  activity  of 
these  muscles  in  the  horse  during  swallowing  is 
easily  perceived  by  the  hand.  Their  energetic 
contraction  is  a  sufficient  explanation  of  the 
rapid  passage  of  water  through  the  oesophagus. 
The  motion  here  is  more  than  five  times  as  rapid 
as  that  of  solids  and  semi-solids. 

Meltzer's  experiment  to  measure  the  rate  of 
liquids  in  man  by  passing  a  stomach  tube  con- 
taining litmus  paper  was  repeated  by  us  with 
some  modifications.  Congo  red  paper  was  used, 
since  it  is  more  sensitive  than  litmus;  it  also 
furnishes  a  means  of  differentiating  between 
mineral  and  organic  acids,  as  the  discolouration 
produced  on  Congo  red  by  mineral  acids  is 
removed  by  ether.  It  was  thus  possible  to  dis- 
tinguish between  the  discolouration  produced  by 
[294] 


The  A,B,'Z,  of  Our  Own  Nutrition 

gastric  regurgitation  and  that  produced  by  the 
swallowed  liquid.  For  the  swallowed  liquid, 
one-half  per  cent  lactic  acid  was  found  most 
satisfactory,  as  the  colour  produced  by  it  on 
Congo  red  test  paper  is  almost  instantly  dis- 
charged in  ether.  By  this  method  the  paper 
was  found  discoloured  within  half  a  second  after 
the  rise  of  the  larynx,  certainly  too  short  a 
period  for  a  peristaltic  wave  to  carry  the  liquid 
to  the  neighbourhood  of  the  cardia. 

The  X-ray  method  lends  itself  less  success- 
fully to  the  study  of  deglutition  in  man  than  in 
the  other  animals  we  have  studied.  The  thick- 
ness of  the  thorax,  the  distance  of  the  oesopha- 
gus from  the  surface,  and  the  relation  to  dense 
tissues  render  the  observation  of  a  swallowed 
mass  difficult,  especially  when  the  mass  is  in 
rather  rapid  motion.  The  few  observations 
which  we  have  to  report  were  made  on  a 
seven-year-old  girl,  placed  in  the  sitting  posture. 
Gelatine  capsules  containing  bismuth  were  used 
for  soHds,  and  were  traced  to  a  point  below  the 
heart.  The  motion  was  very  regular,  and  appar- 
ently due  to  peristalsis,  for  the  bolus  descended 
without  a  hitch  or  irregularity  of  any  kind. 
Sometimes  the  capsule  became  fixed  in  the 
upper  oesophagus,  at  about  the  level  of  the 
second  rib.  Repeated  swallows  of  water  would 
fail  to  dislodge  it.  An  interesting  point  was 
[295] 


The  A.B.'Z,  of  Our  Own  Nutrition 

noted  here.  With  each  attempt  at  swallowing, 
the  capsule  would  rise  slightly,  as  if  the  oesopha- 
gus was  pulled  up  with  the  rise  of  the  larynx ; 
then  the  capsule  would  descend  to  its  former 
position. 

Semi-solids  —  a  mush  of  bread  and  milk  — 
could  be  seen  about  as  far  as  solids ;  that  is,  to 
just  below  the  heart.  The  motion  of  the  mushy 
bolus  was  the  same  as  with  solids,  except  that 
the  rapidity  was  perhaps  slightly  greater. 

It  should  be  noted  here  that  with  the  human 
subject,  as  well  as  with  the  horse,  our  results 
for  semi-solids  differ  from  those  derived  by 
Meltzer's  method ;  for  according  to  his  state- 
ments semi-solids,  like  liquids,  are  squirted  down 
the  oesophagus,  and  are  not  propelled  by  peri- 
stalsis, as  has  been  the  case  in  our  observations. 

Liquids  —  bismuth  and  water  —  were  seen 
only  in  the  neck  and  upper  thorax.  Here  there 
was  a  decided  squirt.  With  the  rise  of  the  lar- 
ynx the  liquid  was  seen  to  pass  rapidly  through 
the  pharynx  and  well  down  into  the  thoracic 
oesophagus  before  it  was  lost  to  observation. 
The  rate,  however,  by  estimation  was  less  than 
that  of  liquids  in  the  horse. 

There  remains  to  be  considered  Meltzer's 
latest  investigation,  in  which  he  endeavoured 
to  ascertain  whether  liquids  remain  above  the 
cardia  till  the  arrival  of  the  peristalsis,  or  ooze 

[  296  ] 


The  A.B,-Z,  of  Our  Own  Nutrition 

down  before.  An  experimental  answer  was  se- 
cured by  Meltzer  by  the  following  method.  The 
abdominal  and  gastric  walls  of  an  anaesthetised 
dog  were  incised,  and  a  tube  (vaginal  speculum) 
introduced.  Through  this  the  entrance  of  food 
into  the  stomach  could  be  observed  directly.  In 
repeated  experiments  no  liquid  was  seen  to  pass 
through  the  cardia  before  the  arrival  of  the 
peristaltic  wave.  An  incision  through  the  dia- 
phragm near  its  anterior  origin  showed  that  the 
swallowed  liquid  was  not  squirted  as  far  as  a 
point  an  inch  above  the  diaphragm.  To  observe 
the  oesophagus  nearer  its  beginning,  the  upper 
three  ribs  were  resected  on  the  left  side.  Thus 
the  swallowed  liquid  was  seen  to  shoot  along 
the  oesophagus  before  any  peristalsis  reached 
this  point.  The  resection  of  the  fifth  rib  ex- 
posed the  oesophagus  half-way  between  the 
bifurcation  of  the  trachea  and  the  diaphragm. 
Here  a  bulging  was  sometimes  observed  imme- 
diately after  the  beginning  of  the  act,  and  the 
swallowed  mass  remained  there  until  a  peri- 
staltic wave  carried  it  down.  If  the  mass  swal- 
lowed was  small,  or  was  projected  with  moderate 
force,  it  might  not  even  reach  as  far  as  the 
bifurcation.  From  these  experiments  Meltzer 
concluded  that  in  animals,  as  in  man,  liquid  food 
is  not  carried  down  the  oesophagus  by  peristal- 
sis, but  is  thrown  rapidly  into  a  deep  part  of 
[297] 


The  A,  B,-Z.of  Our  Own  Nutrition 

the  canal.  The  depth  reached  depends  on  the 
quantity  swallowed,  the  force  used,  and  the 
tonicity  of  the  lower  part  of  the  oesophagus. 

The  difference  between  these  methods  of 
Meltzer  and  those  employed  in  our  experiments 
has  already  been  mentioned ;  and  merely  his 
results,  which  were  obtained  with  liquids  alone, 
need  be  considered  here.  According  to  our 
observations  on  the  dog,  there  was  no  distinct 
pause  at  any  part  of  the  canal.  The  movement 
simply  became  slower,  and  continued  at  this 
rate  until  the  stomach  was  reached.  Neither 
was  the  rate  through  the  diaphragmatic  part  of 
the  oesophagus  slower  than  through  the  thoracic. 
The  quick  propulsive  movement  noticed  in  the 
dog  was  observed  with  solids  and  semi-solids  as 
well  as  with  liquids,  but  the  liquids  descended 
further  down  the  canal  before  the  movement 
changed  to  the  slower  peristalsis.  While  this 
difference  was  evident  to  the  eye,  the  total  time 
consumed  by  liquids  in  passing  from  pharynx 
to  stomach  was  not  enough  shorter  than  the 
time  for  solids  and  semi-solids  to  be  determined 
by  our  measurements. 

Summary. 
The  phenomena  of  oesophageal  deglutition 
as  determined  by  our  experiments  may  then  be 
described  as  follows :  — 

[298] 


The  A,B.-Z,  of  Our  Own  Nutrition 

There  is  a  difference  in  swallowing  according 
to  the  animal  and  the  food  which  is  used. 

In  fowls  the  rate  is  slow  and  the  movement 
always  peristaltic,  without  regard  to  consistency. 
A  squirt-movement  with  liquids  is  manifestly 
impossible,  as  the  parts  forming  the  mouth  are 
too  hard  and  rigid.  With  this  diminution  of  pro- 
pulsive power  in  the  mouth  there  is  observed  a 
greater  reliance  on  the  force  of  gravity.  The 
head  is  raised  each  time  after  the  mouth  is 
filled,  and  the  fluid  by  its  own  weight  trickles 
into  the  oesophagus,  through  which  it  is  carried 
by  peristalsis. 

In  the  cat  the  movement  is  always  peristaltic, 
and  slightly  faster  than  in  fowls.  A  bolus  takes 
from  nine  to  twelve  seconds  in  reaching  the 
stomach.  Liquids  move  somewhat  more  rapidly 
than  semi-solids  in  the  upper  oesophagus.  In 
the  lower  or  diaphragmatic  part  the  rate  is  very 
much  slower  than  above,  and  is  the  same  for 
liquids  as  for  solids. 

In  the  dog  the  total  time  for  the  descent  of 
a  bolus  is  from  four  to  five  seconds.  The  food 
is  always  propelled  rapidly  in  the  upper  oesopha- 
gus, and  moves  more  slowly  below.  This  rapid 
movement  is  frequently  continued  further  with 
liquid  food.  No  distinct  pause  was  observed 
when  the  movement  of  the  bolus  changed  from 
the  rapid  to  the  slower  rate. 
[^99  j 


The  A,B,-  Z,  of  Our  Own  Nutrition 

In  man  and  the  horse  liquids  are  propelled 
deep  into  the  oesophagus  at  a  rate  of  several 
feet  a  second  by  the  rapid  contraction  of  the 
mylohyoid  muscles.  Solids  and  semi-solids  are 
slowly  carried  through  the  entire  oesophagus 
by  peristalsis  alone. 


[  700  J 


THE  MOVEMENTS  OF  THE  STOMACH 

STUDIED  BY  MEANS  OF  THE 

RONTGEN  RAYS 

By  W.  B.  Cannon,  M.D. 

From  tht  Laboratory  of  Physiology  in  the  Harvard  Medical  School 
Extracts  from  A  merican  Journal  of  Physiology,  1898 

Since  the  stomach  gives  no  obvious  external 
sign  of  its  workings,  investigators  of  gastric  move- 
ments have  hitherto  been  obliged  to  confine  their 
studies  to  pathological  subjects  or  to  animals 
subjected  to  serious  operative  interference. 
Observations  made  under  these  necessarily 
abnormal  conditions  have  yielded  a  literature 
which  is  full  of  conflicting  statements  and  uncer- 
tain results.  The  only  sure  conclusion  to  be 
drawn  from  this  material  is  that  when  the 
stomach  receives  food  obscure  peristaltic  con- 
tractions are  set  going,  which  in  some  way 
churn  the  food  to  a  liquid  chyme  and  force  it 
into  the  intestines.  How  imperfectly  this  de- 
scribes the  real  workings  of  the  stomach  will 
appear  from  the  following  account  of  the  actions 
of  the  organ  studied  by  a  new  method.  The  mix- 
ing of  a  small  quantity  of  subnitrate  of  bismuth 
with  the  food  allows  not  only  the  contractions  of 

[301] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

the  gastric  wall,  but  also  the  movements  of  the 
gastric  contents  to  be  seen  with  the  Rontgen 
rays  in  the  uninjured  animal  during  normal 
digestion.  An  unsuspected  nicety  of  mechanical 
action  and  a  surprising  sensitiveness  to  nervous 
conditions  have  thereby  been  disclosed. 

Introductory  Literature 
The  early  writings  on  the  subject  of  gastric 
movements  are  characterised  by  general  infer- 
ences from  physical  laws  and  from  the  anatom- 
ical structure  of  the  stomach.  According  to 
Galen  the  stomach  had  four  functions :  to  draw 
the  food  from  the  mouth  {facultas  attractrix)^ 
to  retain  the  food  (^facultas  retentrix)  during 
the  process  of  chemical  digestion  (^facultas 
alteratrix),  and,  finally,  to  pass  the  changed 
material  onward  (^facultas  expulirix).  In  later 
writings  the  facultas  attractrix  failed  to  appear 
as  one  of  the  functions  of  the  stomach.  Fallo- 
pius,  in  the  sixteenth  century,  changed  the  notion 
of  the  facultas  retentrix  by  suggesting  that  the 
pylorus  alone  performed  this  office,  and  that  the 
muscles  of  the  gastric  wall  could  help  only  by 
remaining  quiet.  Thus  the  facultas  alteratrix 
and  t\\t  facultas  expultrix  are  left  as  true  gastric 
functions.  It  is  with  the  latter  activity  and  its 
effects  that  this  paper  is  concerned. 

The  ideas  of  the  early  writers  concerning  the 
[302] 


l^he  A.  B,-Z.of  Our  Own  Nutrition 

pylorus  and  cardia  are  of  interest.  The  cardia, 
they  were  agreed,  is  closed  during  normal  di- 
gestion in  order  to  keep  the  food  from  re-enter- 
ing the  cesophagus.  The  pylorus  they  looked 
upon  as  the  ruler  of  the  actions  of  the  stomach. 
Such  names  as  pylorus  (keeper  of  the  gate), 
janitor  Justus,  and  rector,  which  the  first  investi- 
gators gave  to  the  sphincter,  indicate  their 
theories  of  its  functions.  The  passage  of  chyme 
into  the  duodenum,  the  keeping  of  undigested 
food  in  the  stomach,  the  act  of  vomiting,  were 
all  dependent,  they  believed,  on  the  "will"  of 
the  pylorus. 

No  substantial  advance  was  made  beyond 
these  hypotheses  until  the  beginning  of  the 
eighteenth  century,  when  Wepfer  and  Schwartz 
applied  the  experimental  method  to  the  study 
of  the  gastric  movements  and  laid  the  foundation 
of  a  more  accurate  knowledge.  Wepfer  vivi- 
sected wolves,  dogs,  and  cats,  and  observed  con- 
strictions following  stimulation  of  the  stomach. 
He  remarked  a  general  contraction  of  the  pyloric 
part  in  vomiting  and  noted  peristaltic  and  anti- 
peristaltic movements  passing  over  the  organ. 
About  the  middle  of  the  stomach  he  frequently 
saw  a  deep  constriction.  The  investigations  of 
Schwartz  are  more  valuable  in  that  his  search 
was  for  the  normal  action  of  the  muscular  coats. 
The  movements,  as  he  observed  them,  were  gen- 
[303] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

erally  only  slight.  They  began  either  at  the 
pylorus  and  passed  to  the  left,  half-way  to  the 
cardia,  or  started  at  the  fundus  and  went  to 
the  pylorus.  The  contractions  and  relaxations, 
following  one  another,  formed  larger  or  smaller 
depressions  and  elevations,  i.  e.y  more  or  less 
definite  waves. 

Near  the  middle  of  the  last  century  Haller, 
after  confirming  the  results  obtained  by  Schwartz 
and  Wepfer,  summarised  his  knowledge  of  the 
motor  functions  of  the  stomach  as  follows.  In 
general,  contraction  alternates  with  relaxation, 
so  that  the  stomach  is,  now  here,  now  there, 
made  narrower  by  longitudinal  or  transverse 
depressions ;  then  in  these  same  places  relaxa- 
tion and  bulging  occur.  So  long  as  both  aper- 
tures are  closed  the  food  is  driven  hither  and 
thither  by  the  shifting  movements.  It  first  takes 
a  definite  direction  when  the  cardia  or  the  pylo- 
rus opens.  If  the  cardia  opens,  there  is  an 
antiperistalsis  followed  by  regurgitation  and 
vomiting.  If,  on  the  contrary,  the  pylorus 
relaxes,  a  contraction,  starting  at  the  oesopha- 
gus, pushes  the  contents  of  the  stomach  into 
the  duodenum.  The  pylorus  allows  the  pas- 
sage of  fluids,  but  if  it  be  stimulated  by  over 
distention  or  by  hard  pieces  of  food,  it  closes 
tightly. 

Such  was  the  knowledge  of  gastric  move- 
[304] 


"The  A,  B.-Z,of  Our  Own  Nutrition 

ments  in  Haller's  time.  A  comparison  of  his 
descriptions  with  those  in  any  standard  work  on 
physiology  published  ten  or  fifteen  years  ago 
will  show  that,  despite  very  many  researches, 
little  advance  had  been  made.  Examinations 
of  animals  and  men  with  gastric  fistulas,  studies 
of  the  stomach  through  the  atrophied  abdominal 
wall,  and  vivisection  have  yielded  numerous  re- 
sults ;  but  these  have  not  been  harmonious,  and 
have  led  to  much  controversy.  Prominent  in 
this  mass  of  material  as  a  valuable  contribution 
are  Beaumont's  careful  observations  through  the 
gastric  fistula  of  Alexis  St.  Martin.  Beaumont's 
work  has  recently  been  confirmed  by  Hofmeister 
and  Schiitz,  who,  with  Rossbach,  Hirsch,  Open- 
chowski,  and  others,  have  presented  during  the 
last  twelve  years  much  new  and  interesting  in- 
formation. Since,  however,  it  will  conduce  to 
clearness  to  set  forth  the  results  of  these  investi- 
gations in  connection  with  my  own  work,  their 
consideration  will  be  deferred  until  later. 

It  will  then  appear  that  these  later  investi- 
gations, Hke  the  earlier  researches,  disagree  as 
to  the  details  of  the  stomach  movements.  Such 
differences  in  results  are  the  proper  outcome  of 
the  abnormal  conditions  under  which  the  studies 
have  been  conducted.  Obviously,  in  order  to  see 
the  natural  movements  of  the  stomach,  the 
organ  should  be  observed  in  its  natural  state, 
^°  [  305  ] 


The  A,B.-Z,  of  Our  Own  Nutrition 

and  not  after  it  has  been  disturbed  by  removal 
from  the  abdomen,  or  by  the  adhesions  and 
losses  of  substance  incident  to  gastric  fistulas. 

As  a  means  of  watching  the  gastric  motor 
activities  under  normal  circumstances,  Dr.  H.  P. 
Bowditch,  in  the  autumn  of  1896,  suggested  the 
use  of  the  Rontgen  rays.  The  present  paper  is 
the  result  of  the  work  thus  far  completed.  The 
kind  assistance  and  stimulating  counsel  of  Dr. 
Bowditch  throughout  the  investigation  are 
gratefully  acknowledged. 


The  Anatomy  of  the  Stomach  and  its 
Relations  to  the  Shadow 

It  must  be  constantly  borne  in  mind  that  the 
shadows  described  in  this  research  are  cast  by 
the  gastric  contents,  not  by  the  stomach  itself. 
Therefore  the  movements  of  the  organ  are  not 
seen  directly,  but  are  indicated  by  their  effect  on 
the  contained  food.  Variations  in  the  length 
and  breadth  of  the  stomach  can  be  inferred  from 
changes  in  the  outline  of  the  shadow,  but  vari- 
ations in  the  front-to-back  diameter  of  the  organ 
must  be  judged  from  changes  in  the  intensity  of 
the  shadow. 

The  form  of  the  active  stomach  soon  after 
food  has  been  taken  is  shown  in  outline  in 
Figure  i.     Since  the  several  parts  of  the  stomach 

[306] 


T^he  A,B,-Z.  of  Our  Own  Nutrition 

are  to  be  mentioned  frequently,  it  will  be  well  to 
recall  them  here  in  their  relations  to  the  outline. 
The  larger,  cardiac  part  of  the  organ  Hes  to  the 
left  of  a  line  through  w  x.  Into  it  the  oesoph- 
agus opens  through  the  cardiac  sphincter,  or 
cardia,  at  c.  The  pyloric  part,  which  includes 
all  of  the  stomach  situated  at  the  right  of  a  line 
w  X,  is  closed  by  the  pylorus  at  p.  This  part 
has  two  divisions :  the  antrum  at  the  right  of  the 
line  y  z,  and  the  preantral  part  of  the  pyloric 


portion,  or  middle  region  of  the  stomach,  be- 
tween the  lines  w  x  and  y  z.  The  lesser  curva- 
ture corresponds  approximately  to  the  anterior 
border  of  the  shadow  c  w  p  ;  the  greater  curva- 
ture to  the  more  extensive  sweep,  c p,  along  the 
posterior  border. 

The  wall  of  the   cat's   stomach  consists   of 

three  coats,  but  as  this  paper  deals  only  with  the 

functions  of  the  muscular  coat,  that  alone  will 

be  described.     The  gastric  muscular  fibres  are 

[307] 


The  A,B,-Z,  of  Our  Own  Nutrition 

disposed  in  three  sets:  an  outer  longitudinal 
layer,  a  middle  circular  layer,  and  a  set  of  inner 
oblique  fibres.  The  longitudinal  fibres  continue 
those  of  the  oesophagus,  and,  radiating  over  the 
cardiac  end,  become  more  marked  along  the 
curvatures  than  on  the  front  and  back  surfaces. 
Over  the  antrum  they  lie  in  a  thick,  uniform 
layer.  The  circular  fibres  form  a  complete 
investment,  and  are  arranged  in  rings  at 
right  angles  to  the  curved  axis  of  the  stomach. 
Towards  the  pyloric  end  they  become  denser  and 
stronger,  and  at  the  pylorus  form  a  thick  bundle, 
the  pyloric  sphincter.  Separating  the  antrum 
from  the  rest  of  the  stomach,  at^  z,  is  a  special 
thickening  of  the  circular  fibres,  called  by  the 
early  writers  the  "transverse  band,"  and  described 
by  Hofmeister  and  Schiitz  as  the  "  sphincter  antri 
pylorici."  The  oblique  fibres  start  from  the  left 
of  the  cardiac  orifice  and  pass  as  two  strong 
bands  along  the  anterior  part  of  the  dorsal  and 
ventral  surfaces,  giving  off  fine  fasciculi  to  the 
circular  musculature ;  towards  the  antrum  they 
gradually  disappear. 

The  musculature  of  the  stomach  consists  of 
smooth  muscle  fibres,  the  chief  physiological 
characteristics  of  which  are  slowness  of  con- 
traction, rhythmic  alternation  of  contraction 
and  relaxation,  and  a  very  great  tonicity,  or 
power  of  prolonged  contraction.  The  action  of 
[308] 


The  A,  B.-Z,of  Our  Own  Nutrition 

these  muscles  in  the  process  of  gastric  digestion 
is  now  to  be  considered. 


The  Normal  Movements  of  the 
Stomach 

Since  the  time  of  Haller  the  chief  con- 
tributors to  the  knowledge  of  the  mechanics  of 
the  stomach  have  been  Beaumont,  Hofmeister 
and  Schiitz,  and  Rossbach, 

Beaumont's  famous  investigations  on  Alexis 
St.  Martin  are  recorded  in  almost  all  general 
works  on  physiology.  Through  a  gastric  fistula 
he  introduced  a  thermometer-tube  and  observed 
how  it  was  affected  by  the  motions  of  the 
stomach.  His  conclusions  are  as  follows :  "  The 
circular  or  transverse  muscles  contract  progres- 
sively from  left  to  right.  When  the  impulse 
arrives  at  the  transverse  bandy  this  is  excited 
to  a  more  forcible  contraction,  and  closing 
upon  the  alimentary  matter  and  fluids  contained 
in  the  pyloric  end,  prevents  their  regurgitation. 
The  muscles  of  the  pyloric  end,  now  contracting 
upon  the  contents  detained  there,  separate  and 
expel  some  portion  of  the  chyme.  .  .  .  After 
the  contractile  impulse  is  carried  to  the  pyloric 
extremity,  the  circular  band  and  all  the  transverse 
muscles  become  relaxed,  and  a  contraction  com- 
mences in  a  reversed  direction,  from  right  to 
[  309  ] 


'The  A,  B.-  Z,of  Our  Own  Nutrition 

left,  and  carries  the  contents  again  to  the  splenic 
extremity  to  undergo  similar  revolutions." 

In  close  accord  with  Beaumont's  description 
of  the  activitives  of  the  human  stomach  are  the 
records  of  the  investigations  on  the  stomach  of 
dogs  by  Hofmeister  and  Schiitz.  They  re- 
moved the  stomach  from  the  body  and  placed  it 
in  a  moist  chamber,  kept  at  body-heat  and 
covered  with  glass.  Under  such  conditions 
the  organ  remained  active  for  from  sixty  to 
ninety  minutes.  A  typical  movement  is  described 
by  these  observers  as  composed  of  two  phases. 
In  the  first  phase  a  constriction  of  the  circular 
fibres,  deeper  on  the  greater  curvature,  starts  a  few 
centimetres  from  the  cardia  and  passes  towards 
the  pylorus.  As  the  constriction  proceeds  it 
increases  in  strength  until  a  maximum  is  reached 
about  two  centimetres  in  front  of  the  antrum. 
This  annular  contraction,  called  by  Hofmeister 
and  Schiitz  the  "  preantral  constriction,"  closes 
the  first  phase.  Immediately  thereafter  the 
strong  sphincter  antri  pylorici,  or  transverse 
band,  contracts.  Now,  while  the  preantral  con- 
striction is  relaxing,  the  sphincter  antri  pylorici 
tightens  still  more,  and  the  antrum  is  shut  off 
from  the  rest  of  the  stomach.  As  soon  as  this 
has  occurred  a  general  contraction  of  the  muscles 
of  the  antrum  follows.  Relaxation  begins  at  the 
sphincter  antri  pylorici  and  progresses  slowly 
[310] 


i:he  A,B.-Z.  of  Our  Own  Nutrition 

towards  the  pylorus;  it  is  sometimes  accom- 
panied by  an  antiperistaltic  movement. 

Although  Rossbach  also  used  dogs,  his  re- 
sults vary  considerably  from  those  of  Hofmeister 
and  Schiitz.  This  discrepancy  is  possibly  ac- 
counted for  by  a  difference  in  method,  for 
Rossbach  left  the  stomach  in  the  body.  The 
dogs  were  treated  with  morphia  and  curare,  and 
the  abdomen  was  then  widely  opened,  so  that  the 
movements  could  be  clearly  seen.  When  the 
stomach  was  full  Rossbach  saw  deep  constric- 
tions begin  near  the  middle  and  pass  in  waves 
to  the  pylorus.  At  first  these  movements  were 
weak ;  later,  however,  they  became  more  vigor- 
ous. The  fundus  remained  in  tonic  contrac- 
tion about  its  contents  and  took  no  part  in  the 
peristalsis. 

Before  attempting  to  explain  the  difference 
in  the  records  of  these  observers  I  shall  give  an 
account  of  what  may  be  seen  in  a  cat  by  use  of 
bismuth  subnitrate  and  the  Rontgen  rays. 

I .  Movements  of  the  pyloric  part.  —  Within 
five  minutes  after  a  cat  has  finished  a  meal  of 
bread,  there  is  visible  near  the  duodenal  end  of 
the  antrum  a  slight  annular  contraction  which 
moves  peristaltically  to  the  pylorus ;  this  is  fol- 
lowed by  several  waves  recurring  at  regular  in- 
tervals. Two  or  three  minutes  after  the  first 
movement  is  seen  very  slight  constrictions  ap- 
[3"] 


l^he  A,B.'Z,  of  Our  Own  Nutrition 

pear  near  the  middle  of  the  stomach,  and  pressing 
deeper  into  the  greater  curvature,  course  slowly 
towards  the  pyloric  end.  As  new  regions  enter 
into  constriction,  the  fibres  just  previously  con- 
tracted become  relaxed,  so  that  there  is  a  true 
moving  wave,  with  a  trough  between  two  crests. 
When  a  wave  swings  round  the  bend  in  the  py- 
loric part  the  indentation  made  by  it  deepens ; 
and  as  digestion  goes  on  the  antrum  elongates  and 
the  constrictions  running  over  it  grow  stronger, 
but  until  the  stomach  is  nearly  empty  they  do 
not  entirely  divide  the  cavity.  After  the  antrum 
has  lengthened,  a  wave  takes  about  thirty-six 
seconds  to  move  from  the  middle  of  the  stomach 
to  the  pylorus.  At  all  periods  of  digestion  the 
waves  recur  at  intervals  of  almost  exactly  ten 
seconds.  So  regular  is  this  rhythm  that  many 
times  I  have  been  able  to  determine  within  two 
or  three  seconds  when  a  minute  had  elapsed 
simply  by  counting  six  similar  phases  of  the 
undulations  as  they  passed  a  given  point.  It 
results  from  this  rhythm  that  when  one  wave  is 
just  beginning  several  others  are  already  running 
in  order  before  it.  Between  the  rings  of  con- 
striction the  stomach  is  bulged  out,  as  shown 
in  the  various  outlines  in  Figures  2,  3,  4,  and  5. 
The  number  of  waves  during  a  single  period  of 
digestion  is  larger  than  might  possibly  at  first 
be  supposed.  In  a  cat  that  finished  eating 
[312] 


"The  A.B.-  Z.  of  Our  Own  Nutrition 

fifteen  grams  of  bread  at  10.52  A.M.,  the  waves 
were  running  regularly  at  ii.oo  o'clock.  The 
stomach  was  not  free  from  food  until  6.12  P.M. 
During  that  time  the  cat  was  fastened  to  the 
holder  at  intervals  of  half  an  hour,  and  the  waves 
were  always  observed  following  one  another  in 
slow  and  monotonous  succession.  At  the  rate 
of  three  hundred  and  sixty  an  hour,  approxi- 
mately two  thousand  six  hundred  waves  passed 
over  the  antrum  during  that  single  digestive 
period. 

From  the  above  review  it  will  be  manifest 
that  my  observations  of  the  movements  of  the 
pyloric  part  agree  closely  with  those  of  Ross- 
bach,  but  differ  considerably  from  the  harmonious 
results  of  the  work  of  Beaumont,  and  Hofmeister 
and  Schiitz.  Beaumont's  methods,  however, 
may  be  justly  criticised  on  the  ground  that  the 
thermometer-tube  which  he  held  in  the  stomach 
was  wholly  unlike  food  and  very  liable  to  bring 
about  unwonted  contractions  in  so  sensitive  an 
organ  as  the  stomach.  Further,  the  movements 
observed  by  Hofmeister  and  Schiitz,  as  Ewald 
has  pointed  out,  may  easily  have  resulted  from 
the  abnormal  stimulus  due  to  lack  of  blood  — 
a  potent  cause  .  of  peristalsis.  And  it  will  be 
shown  later  that  the  accounts  given  by  these 
investigators  describe  very  well  the  actions  of 
the  stomach   when   stimulated  by   an   unusual 

[313] 


The  A.  B.-Z,of  Our  Own  Nutrition 

irritant.  In  this  connection  it  may  be  added 
that  since  the  publication  of  the  preliminary 
notice  of  my  work,  Roux  and  Balthazard,  using 
the  Rontgen  rays,  have  published  the  results  of 
observations  on  the  stomachs  of  the  dog  and 
man  similar  to  those  thus  far  described  in  this 
paper. 

The  fact  that  my  observations  and  those  of 
Roux  and  Balthazard  were  conducted  under 
normal  conditions,  and  that  the  conditions  of 
Rossbach's  experiments  were  more  nearly  normal 
than  those  of  the  other  observers  mentioned, 
warrants  the  conclusion  that  the  pyloric  part 
has  a  more  important  function  than  that  of 
merely  expelling  the  contents  of  the  stomach 
into  the  intestines.  After  summarising  the 
description  given  by  Hofmeister  and  Schiitz, 
Ewald,  for  a  priori  reasons,  declares  :  "  I  cannot 
accept  this  view.  The  plain  fact  that  the  pyloric 
portion  secretes  a  strongly  digesting  fluid  con- 
taining pepsin  and  hydrochloric  acid  proves  it 
to  be  an  important  part  for  the  peptonising 
function  of  the  stomach."  The  account  of  the 
remarkable  manner  in  which  the  pyloric  portion 
performs  this  function  must  be  deferred  until 
the  movements  of  other  parts  of  the  stomach 
have  been  considered. 

2 .  Movemefits  of  the  pyloric  sphincter. — Ross- 
bach  mars  his  otherwise  careful   work   by  de- 

[314] 


The  A.B."  Z.  of  Our  Own  Nutrition 

daring  that  the  pylorus  is  tightly  closed  during 
the  whole  digestive  period  of  from  four  to  eight 
hours,  and  that  then  the  sphincter  relaxes  and 
the  peristaltic  waves  empty  the  stomach.  That 
this  is  not  the  normal  action  of  the  sphincter 
has  been  shown  by  several  observers.  Hirsch 
watched  dogs  with  duodenal  fistulas  and  saw 
food  come  from  the  stomach  at  intervals  of  one- 
fourth  of  a  minute  to  several  minutes.  Roux 
and  Balthazard  maintain  that  in  dogs  food  en- 
ters the  duodenum  at  the  completion  of  each 
wave  of  constriction.  Observations  on  the  cat, 
however,  do  not  support  their  view,  but  agree 
rather  with  the  statement  of  Hirsch. 

In  cats  fed  with  bread  mixed  with  subnitrate 
of  bismuth,  ten  or  fifteen  minutes  elapse  after  the 
first  constriction  in  the  antrum  before  any  food 
can  be  seen  in  the  duodenum.  When  food  does 
appear  it  is  spurted  through  the  pylorus  and 
shoots  along  the  intestine  for  two  or  three 
centimetres.  Not  every  constriction-wave  forces 
food  from  the  antrum.  On  one  occasion,  about 
an  hour  after  the  movements  began,  three  con- 
secutive waves  were  seen,  each  of  which  squirted 
food  into  the  duodenum.  The  pylorus  remained 
closed  against  the  next  eight  waves,  opened  for 
the  ninth,  but  closed  once  more  against  the 
tenth  and  eleventh.  For  each  of  the  four 
succeeding  waves  the  sphincter  relaxed,  but 
[3'5] 


The  A.B.'Z,  of  Our  Own  Nutrition 

blocked  the  food  brought  by  three  constrictions 
that  followed;  and  in  this  irregular  way  the 
food  continued  passing  from  the  stomach.  Near 
the  end  of  gastric  digestion,  when  the  con- 
strictions are  very  deep,  it  may  be  that  the 
pylorus  opens  for  every  wave. 

When  a  hard  bit  of  food  reaches  the  pylorus, 
the  sphincter  closes  tightly  and  remains  closed 
longer  than  when  the  food,  is  soft.  This  action 
of  the  sphincter  was  shown  by  giving  with  the 
regular  food  of  the  cat  a  dry,  hard  pellet  of 
equal  parts  of  starch  paste  and  bismuth  sub- 
nitrate  about  the  size  of  a  pea.  The  food  itself 
contained  merely  enough  bismuth  to  throw  a 
dim  shadow,  near  the  centre  of  which  the  pellet 
could  be  clearly  seen  as  a  dark  object.  The 
continual  passing  of  the  contraction-waves 
finally  brought  the  little  ball  to  the  pylorus. 
When  it  arrived  there,  five  grams  of  bismuth 
subnitrate  were  introduced  into  the  stomach 
through  a  tube  in  the  oesophagus.  This  was 
done  in  order  that  the  food  passing  into  the 
intestines  after  the  ball  came  to  the  pylorus 
might  be  distinguished  from  that  which  had 
gone  on  before.  By  kneading  the  stomach  the 
bismuth  was  distributed,  as  shown  by  the  uni- 
formly black  shadow.  The  pellet  could  still 
be  seen  near  the  end  of  the  antrum  when  the 
constrictions  passed  over  it.     Now,  although  the 


The  A,B.'  Z.  of  Our  Own  Nutrition 

waves  continued  to  run  regularly,  the  very  black 
food  did  not  gather  in  the  intestines  in  sufficient 
amount  to  be  recognised  until  forty-two  minutes 
after  it  had  been  introduced.  And  when,  finally, 
the  food  did  show  itself  in  the  intestines,  its 
shadow  contrasted  strongly  with  that  of  the  food 
which  had  already  passed  on.  The  slowness  of 
the  expulsion  is  not  to  be  regarded  as  wholly 
due  to  the  hard  mass.  No  doubt  the  kneading 
of  the  stomach  mixed  the  contents  of  different 
parts  of  the  organ  and  brought  to  the  pylorus 
food  not  yet  sufficiently  digested  to  be  passed 
by  that  selective  sphincter.  But  this  does  not 
explain  the  whole  delay.  Food  similar  to  that 
given  here,  except  that  it  contained  no  hard 
particles,  has  usually  been  seen  as  small  masses 
in  the  intestines  within  fifteen  minutes  after  being 
swallowed.  A  part  of  the  delay  was  evidently, 
therefore,  caused  by  the  hard  pellet.  Further 
evidence  on  this  point  was  secured  when,  on 
one  occasion,  the  sphincter  was  seen  to  open 
only  seven  times  in  twenty  minutes  following  the 
arrival  of  a  hard  particle  of  food  at  the  pylorus. 
The  conclusion  may  therefore  be  drawn  that 
hard  morsels  keep  the  pylorus  closed  and  hinder 
the  passage  of  the  food  into  the  duodenum. 

3.  Activity  of  the  cardiac  portion,  —  The 
part  played  by  the  fundus  apparently  has  not 
hitherto  been  properly  appreciated.    It  has  been 


The  A.B.-Z.  of  Our  Own  Nutrition 

regarded  as  the  place  for  peptic  digestion,  or 
as  a  passive  reservoir  for  food ;  but  it  is  in  fact 
a  most  interestingly  active  reservoir. 


FlGURB   2. 


[3'8] 


The  A,  B,'Z,of  Our  Own  Nutrition 

The  action  of  the  cardiac  portion  will  be  best 
understood  by  comparing  the  appearances  the 


FiGURB  3. 

Stomach  presents  at  various  stages  in  a  digestive 

period.     In  order  to  show  these  stages  I  care- 

[319] 


The  A,B,-Z,  of  Our  Own  Nutrition 

fully  made  a  set  of  three  tracings  of  the  out- 
lines of  the  stomach  as  soon  as  possible  after  a 
cat  had  finished  eating,  and  another  set  of  three 


Figure  4. 

every  half  hour  thereafter,  until  the  contents  had 
disappeared  (Figs.  2,  3,  4,  and  5).     These  trac- 
ings were  made  by  placing  white  tissue  paper  over 
[320] 


"The  A,  B,-Z,  of  Our  Own  Nutrition 

the  fluorescent  screen,  and  drawing  with  a  thick 
lead  pencil,  easily  seen,  as  much  of  the  boundary 


Figure  5. — Figures  2,  3,  4,  and  5  present  outlines  of  the  shadow 
of  the  contents  of  the  stomach  cast  on  a  fluorescent  screen  by  the 
Rontgen  rays.  The  drawings  were  made  by  tracing  the  outline  of 
the  shadow  on  tissue  paper  laid  upon  the  fluorescent  surface,  and 
are  about  one-half  the  actual  size.  They  show  the  change  in  the 
appearance  of  the  stomach  at  intervals  for  half  an  hour,  from  the 
time  of  eating  until  the  stomach  is  nearly  empty. 

21  [321] 


"The  A,B.-Z,  of  Our  Own  Nutrition 

of  the  stomach  as  I  could  at  the  end  of  each 
expiration.  Between  the  times  for  making  the 
drawings  the  cat  was  allowed  to  rest  quietly  on 
a  mat,  but  care  was  taken  to  lay  her  in  the  same 
position  on  the  holder  for  every  drawing.  The 
drawings  of  each  set  were  afterwards  fastened 
over  one  another,  so  that  the  lines  coincided  as 
closely  as  possible.  Another  piece  of  tissue 
paper  was  then  put  over  these,  and  all  four 
sheets  were  laid  on  an  illuminated  pane  of  glass. 
It  was  thus  easy  to  get  a  composite  tracing 
which,  considering  the  movement  imparted  to 
the  stomach  by  respiration,  and  the  dimness  of 
the  shadows  in  the  later  stages  of  digestion, 
probably  represents  more  exactly  than  any 
single  drawing  the  outline  of  the  stomach  for 
each  successive  period. 

A  comparison  of  these  drawings  shows  that 
as  digestion  proceeds  the  antrum  appears  gradu- 
ally to  elongate  and  acquire  a  greater  capacity, 
and  that  the  constrictions  make  deeper  inden- 
tations in  it.  But  when  the  fundus  has  lost  most 
of  its  contents,  the  longitudinal  and  circular 
fibres  of  the  antrum  contract  to  make  it  again 
shorter  and  smaller.  Its  change  of  form,  how- 
ever, compared  with  the  rest  of  the  stomach, 
is  slight. 

The  first  region  to  decrease  markedly  in  size 
is  the  preantral  part  of  the  pyloric  portion.  The 
[322] 


T^he  A,  B.-Z.  of  Our  Own  Nutrition 

peristaltic  undulations,  caused  by  the  circular 
fibres,  start  at  the  beginning  of  this  portion,  and 
gradually,  by  their  rhythmic  recurrence,  press 
some  of  the  contents  into  the  antrum.  As  the 
process  continues,  the  smooth  muscle  fibres  with 
their  remarkable  tonicity  contract  closely  about 
the  food  that  remains,  so  that  the  middle  region 
comes  to  have  the  shape  of  a  tube  (Figs.  3  and  4 
—  1 .30 P.M.  to  2.30  P.M.),  with  the  rounded  fundus 
at  one  end  and  the  active  antrum  at  the  other. 
Along  the  tube  very  shallow  constrictions  may 
be  seen  following  one  another  to  the  pylorus. 

At  this  juncture  the  longitudinal  fibres  which 
cover  the  fundus  Hke  radiating  fingers,  and  the 
circular  and  oblique  fibres  reaching  in  all  di- 
rections about  this  spherical  region,  begin  to 
contract.  Thus  the  contents  of  the  fundus  are 
squeezed  into  the  tubular  portion.  This  proc- 
ess, accompanied  by  a  slight  shortening  of  the 
tube,  goes  on  until  the  shadow  cast  by  the 
fundus  is  almost  wholly  obliterated  (Fig.  5  — 
5.30  P.M.). 

The  waves  of  constriction  moving  along  the 
tubular  portion  press  the  food  onward  as  fast  as 
they  receive  it  from  the  contracting  fundus,  and 
when  the  fundus  is  at  last  emptied  they  sweep 
the  contents  of  the  tube  into  the  antrum  (Fig.  5 
—  5.00  P.M.  to  6.00  P.M.).  Here  the  operation 
is  continued  by  the  deeper  constrictions  till, 
[  323  ] 


T^he  A.B.-Z,  of  Our  Own  Nutrition 

finally  (in  this  instance  at  6.12  P.M.),  with  the 
exception  of  a  slight  trace  of  food  in  the  fundus, 
nothing  is  to  be  seen  in  the  stomach  at  all. 

The  food  in  the  fundus  may  possibly  be 
slightly  affected  by  the  to-and-fro  movements 
of  the  diaphragm  in  respiration.  With  normal 
breathing  the  upper  border  of  the  cardiac  portion 
swings  through  about  one  centimetre ;  with 
dyspnoea,  or  deep  breathing,  through  one  and  a 
half  or  two  centimetres.  Since  the  lower  border 
does  not  move  so  much,  the  contents  are  gently 
pressed,  and  then  released  from  pressure,  at 
each  respiration.  The  pyloric  portion  is  moved 
very  little  by  the  diaphragm,  the  oscillation 
being  less  than  a  half  centimetre. 

Moritz  has  pointed  out  the  value  of  an  organ 
like  the  stomach  for  holding  the  bulk  of  the  food 
and  serving  it  out  a  little  at  a  time,  so  that  the 
intestines  may  not  become  congested  during 
their  digestive  and  absorptive  processes.  All 
of  the  advantages  supposed  to  be  thus  secured 
to  the  intestines  may  be  claimed  also  for  the 
stomach  itself  For  the  preceding  description 
indicates,  and  experiments  to  be  described  later 
prove,  that  the  stomach  is  composed  of  two 
physiologically  distinct  portions :  the  busy  an- 
trum, over  which  during  digestion  constriction- 
waves  are  running  in  continuous  rhythm ;  and 
the  cardiac  part,  which  is  an  active  reservoir, 
[324] 


The  A.B,-Z,  of  Our  Own  Nutrition 

pressing  out  its  contents  a  little  at  a  time  as  the 
antral  mechanism  is  ready  to  receive  them. 

The  Movements  of  the  Stomach  in 
Vomiting 

The  appearance  of  the  stomach  during  vomit- 
ing has  been  studied  particularly  by  Open- 
chowski.  He  says  that  when  an  emetic  is  given 
there  follows  a  quivering  of  the  stomach-wall, 
which,  beginning  near  the  pylorus,  shows  itself 
later  in  the  antral  and  middle  regions  of  the 
stomach.  The  quivering  afterwards  passes  into 
a  contraction,  most  strongly  marked  in  the 
antral  part,  since  the  peristaltic  waves  running 
down  to  the  antrum  from  above  are  continually 
growing  deeper.  At  the  same  time  the  fundus 
expands  spherically.  The  increased  contraction 
in  the  pyloric  part  drives  the  contents  towards 
the  more  dilated  portion,  and  thence  they 
are  forced  into  the  oesophagus  by  abdominal 
pressure. 

The  same  phenomena  occur  when  a  cat  is 
given  apomorphine  hypodermatically.  First  the 
upper  circular  muscles  relax  and  become  so 
flaccid  that  the  slightest  movement  of  the 
abdomen  changes  the  form  of  the  fundus.  Then 
there  are  apparently  irregular  twitchings  of  the 
fundus  wall.  Soon  a  deep  constriction  starts 
about  three  centimetres  below  the  cardia  and, 

[325] 


The  A.  B.-Z.of  Our  Own  Nutrition 

growing  in  strength,  moves  towards  the  pylorus. 
When  it  reaches  the  transverse  band  the  con- 
striction tightens  and  holds  fast,  while  a  wave 
of  contraction  sweeps  over  the  antrum.  Another 
similar  constriction  follows.  In  the  interval  the 
transverse  band  relaxes  slightly,  but  tightens 
again  when  the  second  wave  reaches  it.  Per- 
haps a  dozen  such  waves  pass;  then  a  firm 
contraction  at  the  beginning  of  the  antrum  com- 
pletely divides  the  gastric  cavity  into  two  parts. 
This  same  division  of  the  stomach  into  two  parts 
at  the  transverse  band  is  to  be  seen  when 
mustard  is  given.  Now,  although  the  waves  are 
still  running  over  the  antrum,  the  whole  preantral 
part  of  the  stomach  is  fully  relaxed.  A  flatten- 
ing of  the  diaphragm  and  a  quick  jerk  of  the 
abdominal  muscles,  accompanied  by  the  open- 
ing of  the  cardia,  now  force  the  contents  of  the 
fundus  into  the  oesophagus.  As  the  spasmodic 
contractions  of  the  abdominal  muscles  are  re- 
peated, the  gastric  wall  again  tightens  around 
the  contained  food.  Antiperistalsis  I  have  seen 
only  once ;  then,  while  the  cat  was  retching,  a 
constriction  started  at  the  pylorus  and  ran  back, 
over  the  antrum,  completely  obliterating  the 
antral  cavity. 

It  will  be  recalled  that  the  principal  differ- 
ence between  the  movements  of  the  stomach  and 
their  effects  as  described  by  Beaumont,  and  Hof- 

[  i^^  ] 


T^he  A.  B.'Z.of  Our  Own  Nutrition 

meister  and  Schiitz  on  the  one  hand,  and  Ross- 
bach,  Roux  and  Balthazard,  and  myself  on  the 
other  hand,  is  that  the  former  observed  con- 
strictions completely  dividing  the  stomach  at  the 
transverse  band,  and  the  antrum  then  squeezing 
its  contents  into  the  intestines  ;  whereas  the  latter 
have  seen  the  constrictions  moving  forward  as 
narrowing  rings,  but  not  separating  the  gastric 
cavity  into  two  parts. 

With  the  exception  of  peristalsis  in  the 
antrum,  the  gastric  movements  at  the  beginning 
of  emesis  are  almost  exactly  the  same  as  those 
Beaumont,  and  Hofmeister  and  Schiitz,  declare 
to  be  the  normal  contractions  of  the  stomach. 
Their  observations  were  made,  however,  when 
the  organ  was  subjected  to  unnatural  stimulation. 
In  the  excised  stomach,  observed  by  Hofmeister 
and  Schiitz,  not  only  were  all  nervous  con- 
nections severed,  but  likewise  all  flow  of  blood 
to  the  organ  was  entirely  stopped,  and  the  cutting 
off  of  the  blood  supply  is  regarded  as  one  of  the 
most  powerful  predisposing  causes  of  peristaltic 
action.  The  thermometer-tube  used  by  Beau- 
mont was  an  irritant  to  the  stomach,  as  he  him- 
self admits.  "  If  the  bulb  of  the  thermometer," 
he  writes,  "  be  suffered  to  be  drawn  down  to  the 
pyloric  extremity,  and  retained  there  for  a  short 
time,  or  if  the  experiments  be  repeated  too 
frequently,  it  causes  severe  distress  and  a  sen- 
[327] 


T^he  A,  B.-  Z.  of  Our  Own  Nutrition 

sation  like  cramp,  or  spasm,  which  ceases  on 
withdrawing  the  tube,  but  leaves  a  sense  of 
soreness  and  tenderness  at  the  pit  of  the 
stomach."  Moritz  also  noticed  that  a  rubber 
sound  introduced  into  the  human  stomach 
proved  to  be  a  source  of  irritation.  It  seems 
reasonable  to  suppose,  therefore,  that  these  ob- 
servers did  not  see  the  normal  movements,  but 
the  actions  resulting  from  abnormal  irritation. 

The  Effect  of  the  Movements  of  the 
Stomach  on  the  Food 

In  my  first  observations  on  the  active 
stomach  a  bulging  of  the  stomach-wall  was  to 
be  seen  in  front  of  the  passing  waves.  But  as 
food  did  not  immediately  appear  in  the  intestine, 
and  as,  after  the  pylorus  relaxed,  the  gastric 
contents  did  not  diminish  rapidly  enough  to 
allow  the  supposition  that  all  of  the  food 
squeezed  forward  by  the  waves  was  immediately 
forced  through  the  pylorus,  it  was  assumed  that 
a  part,  at  least,  of  the  food  under  pressure  was 
forced  back  towards  the  cardia  through  the 
constriction-ring.  This  inference  was  stated  in 
the  preliminary  notice  of  my  work.  Roux  and 
Balthazard  also  observed  the  passage  of  the  un- 
dulations over  the  pyloric  part,  but  state  merely 
that  the  function  of  the  constrictions  is  the 
propulsion  of  food  into  the  intestine,  without 

[328] 


The  A.  B,-Z.of  Our  Own  Nutrition 

mentioning  what  must  be  regarded  as  a  very 
important  function;  namely,  the  mixing  effect 
of  the  waves. 

Most  writers  have  agreed  that  the  result  of 
the  active  and  passive  movements  of  the  stomach 
is  to  force  the  contents  hither  and  thither,  thus 
mixing  them  and  the  gastric  juice  together. 
Two  observers,  Beaumont  and  Brinton,  have  at- 
tempted to  explain  the  manner  of  the  mixing. 
Beaumont,  after  noting  how  the  thermometer- 
tube,  used  by  him  to  indicate  the  gastric  motions, 
was  affected,  describes  the  circulation  of  the  food 
as  follows :  "  The  bolus  as  it  enters  the  cardia 
turns  to  the  left,  passes  the  aperture,  descends 
into  the  splenic  extremity,  and  follows  the 
great  curvature  towards  the  pyloric  end.  It 
then  returns,  in  the  course  of  the  small  curva- 
ture, makes  its  appearance  again  at  the  aperture, 
in  its  descent  into  the  great  curvature,  to  per- 
form similar  revolutions."  Brinton  bases  his 
theory  of  the  circulation  of  the  food  on  an 
analogy  between  the  movement  of  a  constriction 
over  the  stomach  and  the  passage  of  a  septum 
with  a  central  perforation  along  the  interior  of  a 
cylinder  full  of  liquid.  The  result  in  both  cases, 
he  declares,  must  be  a  peripheral  current  of 
advance,  and  a  central  current  of  return.  Thus 
in  the  stomach  there  would  be  peripheral  cur- 
rents from  the  cardia  along  the  walls  of  th© 
[329] 


The  A,  B.'Z.of  Our  Own  Nutrition 

stomach  to  the  pylorus,  where  they  would  unite 
and  run  as  an  axial  current  back  to  the  cardia. 

Certain  a  priori  objections  may  be  urged 
against  each  of  these  conclusions.  In  the  first 
place  Beaumont's  observations  were  made  on  a 
subject  having  a  gastric  fistula,  and  the  adhesions 
between  the  stomach  and  the  abdominal  wall 
would  prevent  the  fundus  from  acting  quite 
normally  in  relation  to  its  contents.  Beaumont's 
conclusions,  furthermore,  are  based  on  the 
movements  of  a  thermometer-tube  introduced 
through  the  fistula,  and  on  the  recognition  of 
particles  of  food  which  he  had  seen  before  as 
they  passed  the  fistulous  opening:  the  first 
method,  as  has  been  shown,  made  the  con- 
ditions in  the  stomach  more  abnormal  than  they 
were  previously;  the  second  gave  uncertain 
knowledge  of  the  course  of  the  food  when  out 
of  the  observer's  sight.  Brinton's  hypothesis 
states  the  probable  movements  of  fluid  contents 
acted  on  by  a  passing  constriction.  But  it  may 
be  objected  that  the  conditions  assumed  by  him 
do  not  exist  in  all  parts  of  the  stomach.  For 
not  only  is  there  no  peristalsis  visible  in  the 
fundus,  but  with  the  usual  food  the  fundus 
contents  are  not  liquid.  Moreover,  the  con- 
strictions at  the  beginning  of  the  pyloric  portion 
are  very  slight  and  move  slowly.  The  food  in 
front  of  them  is,  accordingly,  not  under  much 
[330] 


The  A,  B.'Z.of  Our  Own  Nutrition 

greater  pressure  than  the  food  behind  them. 
The  axial  current  which  might  result,  therefore, 
could  not  be  strong  enough  to  go  far  into  the 
cardiac  portion. 

It  is  easily  possible  to  test  experimentally 
the  validity  of  these  two  theories  by  watching 
the  action  of  pieces  of  food  which  throw  a  black 
shadow  in  a  dimly  outlined  stomach.  For  this 
purpose  little  paste  pellets  of  bismuth  subnitrate, 
with  starch  enough  to  keep  the  form,  were 
given  with  the  customary  meal.  These  pellets, 
it  was  found,  did  not  break  up  in  the  stomach 
during  the  gastric  digestion  of  soft  bread.  Sev- 
eral times  I  have  been  fortunate  in  getting  two 
of  the  little  balls  in  the  axis  of  the  stomach  and 
about  a  centimetre  apart.  As  the  constriction- 
wave  approached  them,  both  moved  forward, 
but  not  so  rapidly  as  the  wave.  Now  when  the 
constriction  overtook  the  first  ball,  the  ball 
moved  backward  through  the  constricted  ring, 
in  the  direction  of  least  resistance.  The  wave 
then  overtook  the  second  ball,  and  it  also  passed 
backward  to  join  its  fellow.  At  the  approach 
of  the  next  wave  they  were  both  pushed  forward 
once  more,  only  to  be  again  forced  backward, 
one  at  a  time,  through  the  narrow  orifice.  As 
the  waves  recurred  in  their  persistent  rhythm, 
the  balls  were  seen  to  be  making  progress  — 
an  oscillating  progress  —  towards  the  pylorus ; 


The  A,  B.-Z.of  Our  Own  Nutrition 

for  they  went  forward  each  time  a  little  farther 
than  they  retreated.  This  to-and-fro  movement 
of  the  pellets  was  much  more  marked  in  the 
antrum,  where  the  waves  were  deep,  than  in  the 
middle  region.  On  different  occasions  from 
nine  to  twelve  minutes  have  elapsed  while  the 
balls  were  passing  from  where  the  waves  first 
affected  them  to  the  pylorus ;  which  means  that 
on  the  way  they  were  moved  back  and  forth  by 
more  than  a  half  hundred  constrictions. 

If  the  pylorus  does  not  relax,  it  is  evident 
that  a  wave  approaching  it  pushes  the  food  into 
a  blind,  elastic  pouch,  the  only  exit  from  which 
is  through  the  advancing  constricted  ring.  The 
constrictions  are  deeper  near  the  end  of  the 
antrum,  and  the  rings  are  small ;  consequently, 
the  food  is  squirted  back  through  them  with 
considerable  violence.  As  has  been  noted,  the 
pylorus  opens  less  frequently  for  a  while  after  a 
solid  piece  of  food  comes  to  it.  In  such  a  case 
the  slow  driving  waves  squeeze  the  hard  morsel 
and  the  soft  food  about  it  up  to  the  sphincter, 
only  to  have  the  whole  mass  shoot  back,  some- 
times half-way  along  the  antrum.  Over  and 
over  again  the  process  is  repeated  till  the 
sphincter  at  last  opens  and  allows  the  more  fluid 
parts  to  pass.  Hofmeister  and  Schiitz,  and 
Moritz  have  disclaimed  any  selective  action  of  the 
pylorus,  and  declare  that  solids  are  driven  from 
[332] 


"The  A,  B,-Z.of  Our  Own  Nutrition 

the  pylorus  to  the  fundus  by  antiperistalsis. 
The  action  of  the  pylorus  which  I  have  seen, 
however,  is  more  like  that  described  by  the 
earlier  investigators ;  for  during  digestion  there 
was  no  antiperistalsis,  and  the  sphincter,  separat- 
ing the  fluids  from  the  solids,  caused  the  solids 
to  remain  and  undergo  a  tireless  rubbing. 
Frequently,  when  several  of  these  balls  have 
been  given  at  the  same  time,  they  have  all  been 
seen  in  the  antrum  after  the  stomach  was  other- 
wise empty.  Here  they  remain  to  be  softened 
in  time  by  the  juices,  or  to  be  forced  through  the 
pylorus  later,  for  solids  do  pass  into  the  intes- 
tine. Thus  when  the  teeth  neglect  their  work 
the  stomach  attempts  to  perform  their  function ; 
the  relative  inefficiency  of  the  gastric  method  of 
grinding  and  its  interference  with  the  normal 
gastric  activities  point  an  obvious  hygienic 
moral. 

During  the  process  of  digestion  the  food  in 
the  cardiac  portion  gives  no  sign  of  currents. 
Balls  which  lie  in  the  fundus  immediately  after 
the  food  is  ingested  keep  their  relative  positions 
until  the  cardiac  portion  begins  to  contract,  and 
then  move  very  slowly  towards  the  antrum. 
Moreover,  the  food  in  the  fundus  of  a  cat  has 
the  same  mushy  appearance  when  examined 
after  gastric  peristalsis  had  been  active  for  an 
hour  and  a  half  that  it  had  when  ingested.  The 
[333] 


T^he  A.  B,-Z,of  Our  Own  Nutrition 

contents  of  the  antrum,  on  the  other  hand,  look 
quite  different  and  have  the  consistency  of  thick 
soup.  The  inactivity  of  the  food  in  the  fundus 
can  also  be  proved  by  feeding  first  five  grams 
of  bread  and  bismuth,  then  five  grams  with- 
out bismuth,  and  finally  five  grams  again  with 
bismuth  in  it.  The  stomach  contents  are  thus 
arranged  in  two  dark  layers  along  the  curva- 
tures, with  a  light  layer  between.  Tracings 
made  on  tissue  paper  show  that  ten  minutes 
after  peristalsis  commenced  the  stratification 
had  entirely  disappeared  in  the  pyloric  part,  but 
that  an  hour  and  twenty  minutes  thereafter  the 
layers  were  still  clearly  visible  in  the  cardiac 
region. 

The  value  of  the  circulation  of  the  food,  as 
described  by  Beaumont  and  Brinton,  lay  in  the 
supposition  that  the  contents  of  the  stomach 
were  thus  brought  near  to  the  secreting  gastric 
wall,  and  that  the  gastric  juice  could  thus  more 
readily  exert  its  action.  Although  my  obser- 
vations do  not  support  their  theories  of  mixing 
currents  running  throughout  the  stomach,  they 
still  show  that  the  pyloric  portion  is  an  admi- 
rable device  for  bringing  all  of  the  food  under 
the  influence  of  the  glandular  secretions  of  that 
region.  For,  when  a  constriction  occurs,  the 
secreting  surface  enclosed  by  the  ring  is  brought 
close  around  the  food  lying  within  the  ring  in 
[334] 


l^he  A.  B.'Z.of  Our  Own  Nutrition 

the  axis  of  the  stomach.  As  this  constriction 
passes  on,  fresh  areas  of  glandular  tissue  are 
continuously  pressed  in  around  the  narrow  ori- 
fice. And  also,  as  the  constriction  passes  on, 
a  thin  stream  of  gastric  contents  is  continuously 
forced  back  through  the  orifice,  and  thus  past  the 
mouths  of  the  glands.  The  result  of  this  ingen- 
ious mechanism  is  that  every  part  of  the  secret- 
ing surface  of  the  pyloric  portion  is  brought 
near  to  every  bit  of  food,  before  the  latter  leaves 
the  stomach,  a  half  hundred  times  or  more,  as 
evidence  by  the  moving  ball. 

Salivary  Digestion  in  the  Stomach 

The  absence  of  movement  in  the  fundus 
would  seem  to  give  the  food  during  its  stay  there 
little  opportunity  to  become  mixed  with  the 
gastric  juices,  and  thus  to  undergo  peptic  diges- 
tion. The  truth  of  this  supposition  can  easily 
be  proved  experimentally  by  feeding  a  slightly 
alkaline  meal,  and  later  testing  the  chemical 
reaction  of  the  contents  of  various  parts  of  the 
stomach.  A  cat  which  had  been  without  food 
for  fifteen  hours  was  given  eighteen  grams  of 
mushy  bread  made  slightly  alkaline  with  sodium 
carbonate.  One  hour  and  a  half  after  the  cat 
had  finished  eating  she  was  killed,  and  the 
stomach  laid  bare  by  opening  the  abdomen.  A 
very  small  hole  was  then  made  through  the  wall 
[335] 


The  A.B.-Z,  of  Our  Own  Nutrition 

in  the  fundus  region,  and  another  similar  hole 
was  made  into  the  antrum.  By  means  of  a 
glass  pipette  food  was  extracted  first  from  the 
periphery  of  the  fundus ;  this  food  was  slightly 
acid.  The  cleaned  pipette  was  then  introduced 
two  and  a  half  centimetres  into  the  fundus  con- 
tents, and  the  food  thus  extracted  gave  the 
original  alkaline  reaction.  Specimens  of  the 
liquid  contents  of  the  antral  and  middle  regions, 
taken  from  various  depths,  were  all  strongly 
acid.  A  dog  killed  an  hour  and  three-quarters 
after  eating  showed  similiar  differences  between 
the  reactions  of  the  food  in  the  fundus  and  the 
food  in  the  pyloric  portion.  So,  as  a  matter  of 
fact,  the  food  does  not  become  acid  at  a  uni- 
form rate  in  all  parts  of  the  stomach,  as  would 
be  the  case  if  Beaumont's  and  Brinton's  theories 
of  mixing  currents  were  true.  Moreover,  if  the 
facts  accorded  with  their  notions,  the  saliva, 
which  ceases  to  act  in  the  presence  of  more  than 
0.003  P^J*  cent  free  hydrochloric  acid,  and  is 
destroyed  when  the  percentage  of  acid  proteids 
is  large,  would  manifestly  have  its  service  as  a 
ferment  limited  to  the  relatively  short  time  dur- 
ing which  the  stomach  contents,  in  the  process 
of  thorough  mixing,  were  reaching  that  degree 
of  acidity.  There  is,  however,  no  movement  of 
food  in  the  fundus,  and  the  alkaline  food  received 
from  the  oesophagus   remains  alkaline    in  this 

r  336 1 


T^he  A,B.-Z.  of  Our  Own  Nutrition 

region  for  a  considerable  period.  The  nutri- 
ment, therefore,  if  well  chewed  and  thus  mixed 
with  saliva,  can  undergo  salivary  digestion  in 
the  fundus  for  a  considerable  period  without 
interference  by  the  acid  gastric  juice.^ 

From  all  these  observations  the  conclusion 
must  be  that  the  fundus  acts  as  a  reservoir  for 
the  food,  in  which  the  digestion  of  sugars  and 
starches  may  take  place ;  and  that  the  pyloric 
portion  with  its  simple  but  marvellous  peristaltic 
mechanism,  by  a  single  process,  triturates  the 
food,  brings  it  near  to  the  active  glands,  stirs  it 
thoroughly  with  their  secretions,  and  expels  the 
products  into  the  intestines. 

The  Inhibition  of  Stomach  Movements 
DURING  Emotion 

Early  in  the  research  a  marked  unlikeness 
was  noticed  in  the  action  of  the  stomachs  of  male 
and  female  cats.  The  peristalsis  seen  with  only 
a  few  exceptions  in  female  cats  failed  to  appear 
in  most  of  the  males,  although  both  had  received 
exactly  the  same  treatment.  Along  with  this  dif- 
ference was  a  very  striking  difference  in  behaviour 

1  An  investigation  by  Cannon  and  Day  {American  Journal 
ef  Physiology,  1903)  has  confirmed  this  conclusion.  An  hour 
after  starchy  food  mixed  with  saliva  was  ingested  a  unit  vol- 
ume of  the  food  in  the  cardiac  end  of  the  stomach  contained 
almost  twice  the  amount  of  sugar  found  in  a  unit  volume  of 
the  food  in  the  pyloric  end. 

"  [ 337  ] 


"The  A,B.-Z.  of  Our  Own  Nutrition 

when  bound  to  the  holder ;  the  females  would 
lie  quiet,  mewing  occasionally,  but  purring  as 
soon  as  they  were  gently  stroked.  The  males, 
on  the  contrary,  would  fly  into  a  violent  rage, 
struggle  to  be  loose  from  their  fastenings,  bite 
at  everything  near  their  heads,  cry  loudly,  and 
resist  all  attempts  to  quiet  them.  On  account 
of  this  difference  only  female  cats  were  used  for 
some  time,  and  the  significance  at  first  attrib- 
uted to  the  action  of  the  males  was  almost  for- 
gotten when  the  following  incident  recalled  it 
and  suggested  that  the  excitement  caused  the 
suspension  of  the  stomach  movements.  On 
October  23,  1897,  ^  "lale  cat  was  fed  at  12.00, 
but  was  not  placed  on  the  holder  till  ninety 
minutes  later.  The  waves  were  passing  at  the 
rate  of  six  a  minute.  The  cat  fell  into  a  rage 
and  the  waves  suddenly  stopped. 

A  few  days  later  an  observation  on  a  female 
with  kittens  explained  the  absence  of  gastric 
movements  in  the  males.  While  the  peristaltic 
undulations  were  coursing  regularly  over  the  cat's 
stomach,  she  suddenly  changed  from  her  peace- 
ful sleepiness,  began  to  breathe  quickly,  and 
struggled  to  get  loose.  As  soon  as  the  change 
took  place,  the  movements  in  the  stomach 
entirely  disappeared ;  the  pyloric  portion  re- 
laxed and  presented  a  smooth,  rounded  outline. 
I  continued  observing,  and  stroked  the  cat  reas- 

[338] 


T^he  A.  B.-Z.of  Our  Own  Nutrition 

suringly.  In  a  moment  she  became  quiet  and 
began  to  purr.  As  soon  as  this  happened  the 
movements  commenced  again  in  the  stomach ; 
first  a  few  constrictions  were  visible  near  the  end 
of  the  antrum,  then  a  few  near  the  sharp  bend 
in  the  lesser  curvature,  and  finally  the  waves 
were  running  normally  from  their  habitual  start- 
ing-place. By  holding  the  cat's  mouth  closed 
between  the  thumb  and  last  three  fingers,  and 
covering  her  nostrils  with  the  index  finger,  she 
could  be  kept  from  breathing.  At  the  first  sign 
of  discomfort  the  fingers  were  removed.  This 
experiment  was  repeated  a  great  many  times  on 
different  cats,  and  invariably  the  evidence  of 
distress  was  accompanied  by  a  total  suspension 
of  the  motor  activities  of  the  stomach  and  a 
relaxation  of  the  antral  fibres. 

No  amount  of  kneading  or  compression  of 
the  abdomen  with  the  fingers,  short  of  making 
the  cat  angry,  would  cause  the  waves  to  stop ; 
so  that  the  cat's  movements,  in  themselves, 
were  not  the  source  of  the  inhibition.  And 
since  expressions  of  strong  feeling  on  the  part 
of  the  animal  always  accompanied  cessation  of 
the  constriction-waves,  the  inhibition  was  prob- 
ably due  to  nervous  influence.  It  has  long 
been  common  knowledge  that  violent  emotions 
interfere  with  the  digestive  process,  but  that  the 
gastric  motor  activities  should  manifest  such 
[339] 


The  A.B,-  Z,  of  Our  Own  Nutrition 

extreme  sensitiveness  to  nervous  conditions  is 
surprising. 

Summary 

1.  By  mixing  a  harmless  powder,  subnitrate 
of  bismuth,  with  the  food,  the  movements  of  the 
stomach  can  be  seen  by  means  of  the  Rontgen 
rays. 

2.  The  stomach  consists  of  two  physiolog- 
ically distinct  parts:  the  pyloric  part  and  the 
fundus.  Over  the  pyloric  part,  while  food  is 
present,  constriction-waves  are  seen  continually 
coursing  towards  the  pylorus ;  the  fundus  is  an 
active  reservoir  for  the  food  and  squeezes  out 
its  contents  gradually  into  the  pyloric  part. 

3.  The  stomach  is  emptied  by  the  formation, 
between  the  fundus  and  the  antrum,  of  a  tube 
along  which  constrictions  pass.  The  contents 
of  the  fundus  are  pressed  into  the  tube  and  the 
tube  and  antrum  slowly  cleared  of  food  by  the 
waves  of  constriction. 

4.  The  food  in  the  pyloric  portion  is  first 
pushed  forward  by  the  running  wave,  and  then 
by  pressure  of  the  stomach-wall  is  returned 
through  the  ring  of  constriction ;  thus  the  food 
is  thoroughly  mixed  with  gastric  juice,  and  is 
forced  by  an  oscillating  progress  to  the  pylorus. 

5.  The  food  in  the  fundus  is  not  moved  by 
peristalsis,  and  consequently  it  is  not  mixed  with 

[340] 


The  A,B,-  Z,  of  Our  Own  Nutrition 

the  gastric  juice;  salivary  digestion  can  there- 
fore be  carried  on  in  this  region  for  a  consider- 
able period  without  being  stopped  by  the  acid 
gastric  juice. 

6.  The  pylorus  does  not  open  at  the  approach 
of  every  wave,  but  only  at  irregular  intervals. 
The  arrival  of  a  hard  morsel  causes  the  sphinc- 
ter to  open  less  frequently  than  normally,  thus 
materially  interfering  with  the  passage  of  the 
already  liquefied  food. 

7.  Solid  food  remains  in  the  antrum  to  be 
rubbed  by  the  constrictions  until  triturated,  or 
to  be  softened  by  the  gastric  juice,  or  later 
it  may  be  forced  into  the  intestine  in  the  solid 
state. 

8.  The  constriction- waves  have,  therefore, 
three  functions  :  the  mixing,  trituration,  and 
expulsion  of  the  food. 

9.  At  the  beginning  of  vomiting,  the  gastric 
cavity  is  separated  into  two  parts  by  a  constric- 
tion at  the  entrance  to  the  antrum ;  the  cardiac 
portion  is  relaxed,  and  the  spasmodic  contrac- 
tions of  the  abdominal  muscles  force  the  food 
through  the  opened  cardia  into  the  oesophagus. 

10.  The  stomach  movements  are  inhibited 
whenever  the  cat  shows  signs  of  anxiety,  rage, 
or  distress. 


[341] 


THE  MOVEMENTS  OF  THE  INTES- 
TINES STUDIED  BY  MEANS  OF 
THE   RONTGEN   RAYS ^ 

By  W.  B.  Cannon 

From  the  Laboratory  of  Physiology  in  the  Harvard  Medical  School 
Extracts  from  American  Journal  of  Physiology,  1902 

Introduction 

The  investigation  of  intestinal  movements 
has  been  beset  by  the  same  difficulties  that 
characterised  the  investigation  of  the  gastric 
mechanism.  Pathological  subjects  or  animals 
subjected  to  the  disturbing  action  of  drugs  and 
anaesthetics  and  of  serious  operations  have  been 
the  only  sources  of  our  knowledge.  A  consid- 
erable difference  of  opinion  as  to  the  nature  of 
the  normal  movements  in  the  intestines  has 
resulted  from  observations  made  under  these 
necessary  abnormal  conditions.  The  slowly 
advancing  peristaltic  wave  and  the  Pendelbe- 
wegungy  or  swaying  movement,  described  by 
Ludwig,  have  been  regarded  as  true  physiolog- 
ical processes.     Concerning  antiperistalsis  and 

^  The  results  of  this  investigation  were  reported  to  the 
Boston  Society  of  Medical  Sciences,  November  19,  1901. 

[342] 


The  A.  B.-Z,of  Our  Own  Nutrition 

the  swiftly  running  vermicular  contraction,  ob- 
servers are  not  so  nearly  in  agreement.  The 
activity  of  the  large  intestine  has  been  described 
as  simply  peristalsis  of  a  slower  rate  than  that 
seen  in  the  small  intestine. 

The  best  known  of  the  intestinal  movements 
is  the  normal  peristaltic  wave.  This  wave  is 
slow,  having  a  rate  of  about  two  centimetres 
per  minute,  is  regular,  and  by  most  observers 
is  said  to  move  always  in  one  direction.  The 
progress  of  the  contraction,  as  suggested  by 
Nothnagel's  experiments,  and  as  clearly  stated 
by  Mall  and  by  Bayliss  and  Starling,  is  dependent 
upon  a  local  reflex.  According  to  Mall,  when 
an  object  stimulates  the  mucosa  there  occurs 
above  the  point  of  stimulation  a  constriction 
which  forces  the  object  downward ;  and  as 
it  moves  downward  new  regions  immediately 
above  the  mass  are  by  this  reflex  brought  into 
constriction,  and  thus  the  wave  and  its  stimulus 
advance  together.  "  At  the  same  time,"  Mall 
states,  "  a  sucking  force,  due  to  active  dilatation 
below  the  body,  may  have  a  tendency  to  drag 
it  down."  In  what  manner  an  active  dilatation 
of  the  intestinal  wall  may  occur  so  as  to  pro- 
duce a  "  sucking  force "  he  does  not  make 
wholly  clear.  Bayliss  and  Starling,  in  describ- 
ing normal  peristalsis  in  the  intestine,  state  that 
the  contractions  above  the  bolus  increase  until 
[343] 


The  A,  B,'Z,of  Our  Own  Nutrition 

there  is  a  strong  tonic  constriction.  This  passes 
the  bolus  onward,  and  jas  it  advances  the  ring 
of  constriction  follows  it.  While  the  bolus  is 
passing  down,  the  gut  above  it  is  traversed  by 
waves  running  as  far  as  the  constricted  ring. 
These  observers  state  the  law  of  intestinal  peris- 
talsis thus :  *'  Local  stimulation  of  the  gut  pro- 
duces excitation  above  and  inhibition  below  the 
excited  spot." 

The  pendulum  movements  are  characterised 
by  a  gentle  swaying  motion  of  the  coils,  and  are 
accompanied  by  rhythmical  contractions  of  the 
intestinal  wall.  They  continue  with  undimin- 
ished force  after  paralysis  of  the  local  nervous 
mechanism  by  nicotine  or  cocaine;  they  have 
been  called,  therefore,  myogenic  or  myodromic 
contractions.  Observers  have  described  them 
variously  as  shortenings  and  narrowings  of  the 
gut,  rhythmically  repeated  at  nearly  the  same 
intestinal  circumference;  as  alternating  to-and- 
fro  movements  of  the  long  axis  without  changes 
in  the  lumen;  as  local  or  extensive  periodic 
contractions  and  relaxations  mainly  of  the  circu- 
lar musculature ;  and  as  waves  involving  both 
muscular  coats  of  the  intestine,  and  traveUing 
normally  from  above  downward  at  a  rapid  rate 
(2  to  5  cm.  per  second).  They  have  been  seen 
in  the  dog,  and  in  the  rabbit  and  cat.  In  the 
cat  Bayliss  and  Starling  noticed  that  when  the 
[344] 


The  A,  B,-Z,of  Our  Own  Nutrition 

Jumen  of  the  gut  was  distended  by  a  rubber 
balloon,  there  appeared  rhythmical  contractions, 
which  nearly  always  were  most  marked  at  about 
the  middle  of  the  balloon ;  i.  e.,  the  region  of 
greatest  tension.  This  form  of  constriction, 
which,  as  my  observation  shows,  is  an  indication 
of  the  manner  in  which  the  rhythmical  contrac- 
tion acts  in  the  cat's  intestine,  Bayliss  and  Star- 
ling seem  to  have  regarded  with  slight  attention, 
since  it  did  not  accord  with  the  law  of  peristalsis. 

The  swift  vermicular  wave  may  pass  the 
whole  length  of  the  intestine  in  about  a  minute. 
It  is  often  seen  just  after  death,  as  well  as  in 
pathological  states  such  as  intestinal  anaemia  or 
hyperaemia,  and  when  the  bowel  contains  gases 
and  organic  acids  from  decomposing  food. 
Starling  is  inclined  to  regard  this  type  of  intes- 
tinal activity  as  an  exaggeration  of  the  rhyth- 
mic type ;  Mall,  on  the  other  hand,  places  it  in 
a  class  by  itself,  and  declares  that  its  service 
is  to  rid  the  intestine  rapidly  of  irritating  sub- 
stances. Nothnagel,  who  designates  this  form 
of  movement  with  the  term  Rollbewegutig,  thinks 
it  is  transitional  between  a  physiological  and  a 
pathological  activity. 

The  existence  of  antiperistalsis  has  been  so 
much  questioned  that  it  will  be  considered  in  a 
special  section  of  this  paper,  where  my  observa- 
tions may  be  conveniently  introduced. 
[345] 


The  A.  B,-Z.  of  Our  Own  Nutrition 

The  common  understanding  of  the  manner 
in  which  food  passes  through  the  intestinal 
canal  is  that  the  chyme  ejected  from  the  stom- 
ach is  pressed  downward  by  a  peristalsis,  which 
passes  slowly  over  a  part  or  all  of  the  small  in- 
testine. The  peristaltic  waves  of  the  colon  are 
supposed  to  constitute  an  independent  group, 
similar  to  those  of  the  small  intestine,  but 
weaker  and  slower.  Movements  of  the  food 
other  than  the  uninterrupted  advance  have  been 
mentioned  by  some  observers.  Starling  states 
that  the  effect  of  the  pendulum  movement  is 
to  mix  the  contents  of  the  intestine  and  bring 
them  into  intimate  contact  with  the  mucous 
membrane.  Griitzner  writes  that  he  has  been 
brought  "  by  strange  and  peculiar  observa- 
tions" to  believe  that  the  fluid  contents  of  the 
small  intestine  move  irregularly  forward,  then 
forward  and  back,  then  perhaps  remain  quiet 
for  some  time,  only  to  pass  backward  for  a  long 
distance,  and  finally  to  move  forward  steadily  to 
the  end.  In  this  manner  the  food  is  mixed  and 
brought  into  contact  with  the  absorbing  walls. 
The  to-and-fro  shiftings  of  the  food  Griitzner 
ascribed  to  advancing  and  retrograde  contrac- 
tions of  the  intestinal  musculature,  and  he 
argued  that  even  circular  constrictions  must 
force  the  liquid  contents  away  in  both  direc- 
tions.     To    support    his   contention,    Griitzner 

[346] 


7he  A,  B.-Z,of  Our  Own  Nutrition 

introduced  mercury  into  the  intestine  and  ob- 
served it  with  the  Rontgen  rays.  After  noting 
a  backward  and  forward  movement  of  the  mer- 
cury he  dismissed  the  method,  saying,  **  Many 
a  flash  must  come  from  the  Rontgen  tube  be- 
fore the  normal  movement  of  the  intestinal  con- 
tents is  made  entirely  clear  by  this  method." 

The  following  account  is  a  summary  of  many 
repeated  observations  on  different  animals,  and 
is  a  contribution  to  a  clear  understanding  of  the 
normal  movements  of  the  intestines  and  their 
contents. 

The  Movements  of  the  Small  Intestine 

When  the  food  has  been  distributed  through 
the  intestine  so  as  to  present  the  appearance 
shown  in  Figure  i,  a  noticeable  feature  in  most 
or  all  of  the  loops  is  the  total  absence  of  move- 
ment. If  the  animal  remains  quiet,  however, 
only  a  few  moments  elapse  before  peculiar 
motions  appear  in  one  or  another  of  the  loops, 
or  perhaps  in  several,  and  last  for  some  time. 
These  motions  consist  in  a  sudden  division  of 
one  of  the  long,  narrow  masses  of  food  into 
many  little  segments  of  nearly  equal  size  ;  then 
these  segments  are  again  suddenly  divided  and 
the  neighbouring  halves  unite  to  make  new  seg- 
ments, and  so  on,  in  a  manner  to  be  more  fully 
described.  I  have  called  this  process  the  rhyth- 
[  347  ] 


The  A.  B.'  Z.  of  Our  Own  Nutrition 


mic  segmentation  of  the  intestinal  contents. 
Further  observation  reveals  peristalsis  here  and 
there,  and  under  certain  circumstances  the 
typical  swaying  movements  may  be  seen.     All 

these   phenomena  are 

now  to  be  considered 
in  detail. 

Rhythmic  segmen- 
tation of  the  intestinal 
contents.  —  This  is  by 
far  the  most  common 
and  the  most  interest- 
ing mechanical  process 
to  be  seen  in  the  small 
intestine.  The  nature 
of  the  process  may 
best  be  understood  by 
referring  to  the  dia- 
gram in  Figure  2.  A 
string-like  mass  of  food 
is  seen  lying  quietly  in 
one  of  the  intestinal  loops  (line  i,  Fig.  2).  Sud 
denly  an  undefined  activity  appears  in  the  mass, 
and  a  moment  later  constrictions  at  regular  in 
tervals  along  its  length  cut  it  into  little  ovoid 
pieces.  The  solid  string  is  thus  quickly  trans- 
formed, by  a  simultaneous  sectioning,  into  a 
series  of  uniform  segments.  A  moment  later 
each  of  these  segments  is  divided  into  two  par- 

[348] 


Figure  i.  —  Appearance  of  food 
in  the  intestines  5^  hours  after 
eating.  This  and  other  radio- 
graphs reduced  two-thirds. 


T^he  A.B.-  Z.  of  Our  Own  Nutrition 

tides,  and  immediately  after  the  division  neigh- 
bouring particles  (as  a  and  b,  line  2,  Fig,  2)  rush 
together,  often  with  the  rapidity  of  flying  shut- 
tles, and  merge  to  form  new  segments  (as  c,  line 
3,  Fig.  2).  The  next  moment  these  new  seg- 
ments are  divided,  and  neighbouring  particles 
unite  to  make  a  third  series,  and  so  on.  At 
the  time   of  the   second   segmentation   (line   3, 


,     oOOOOoo 

Figure  2. —  Diagram  representing  the  process  of  rhythmic  seg- 
mentation. Lines  i,  2,  3,  4  indicate  the  sequence  of  appearances 
in  the  loop.  The  dotted  lines  mark  the  regions  of  division.  The 
arrows  show  the  relation  of  the  particles  to  the  segments  they 
subsequently  form. 

Fig.  2)  the  end  particles  are  left  small.  Obser- 
vation shows  that  these  small  pieces  are  not  re- 
divided.  The  end  piece  at  A  simply  varies  in 
size  with  each  division ;  at  one  moment  it  is  left 
small,  at  the  next  moment  it  is  full  size  from  the 
addition  of  a  part  of  the  nearest  segment,  and  a 
moment  later  is  the  small  bit  left  after  another 
division.  The  end  piece  at  B  (probably  the  rear 
of  the  mass)  shoots  away  when  the  end  mass  is 
divided,  and  is  swept  back  at  each  reunion  to 
[349] 


The  A.  B.-  Z,  of  Our  Own  Nutrition 

make  the  large  end  mass  again,  only  to  be  shot 
away  and  swept  onward  with  each  recurrence  of 
the  constrictions.  Thus  the  process  of  repeated 
segmentation  continues,  with  the  little  particles 
flitting  towards  each  other  and  the  larger  seg- 
ments shifting  to  and  fro,  commonly  for  more 
than  half  an  hour  without  cessation.  From  the 
beginning  to  the  end  of  a  period  of  segmenta- 
tion the  food  is  seen  to  have  changed  its  posi- 
tion in  the  abdomen  to  only  a  slight  extent; 
whether  this  change  is  a  passing  of  the  food 
along  the  loop,  or  a  movement  of  the  loop 
itself,  it  is  impossible  to  tell  from  the  shadows 
on  the  screen.  The  change  of  position,  how- 
ever, is  much  less  conspicuous  than  the  lively 
division  and  redivision  which  the  mass  suffers  so 
many  times  from  the  busy,  shifting  constrictions. 
From  this  typical  form  of  rhythmic  segmen- 
tation there  are  several  variations.  Sometimes, 
and  especially  when  the  mass  of  food  is  thick, 
the  constrictions  do  not  make  complete  divisions 
and  are  so  far  apart  that  the  intermediate 
portions  are  relatively  large.  Moreover,  the 
constrictions  do  not  take  place  in  the  middle  of 
each  portion,  but  near  one  end ;  thus  each 
portion  is  constricted,  not  into  halves,  but  into 
thirds.  If  a  little  pointer  is  placed  at  the  middle 
of  a  segment,  when  the  segments  are  completely 
divided  into  halves,  in  a  few  seconds  the  pointer 
[350] 


The  A,  B,-Z,  of  Our  Own  Nutrition 

will  be  in  the  middle  of  the  clear  space  between 
two  segments;  but  in  a  few  seconds  more  the 
first  phase  will  return  and  the  pointer  will  again 
be  indicating  a  segment,  —  two  operations  inter- 
vene between  similar  phases.  When,  however, 
the  portions  are  constricted  into  thirds,  the  indi- 
cator shows  it,  since  three  operations  intervene 
between  similar  phases.  The  manner  of  these 
changes  is  made  clearer  by  reference  to  the 
diagram  in  Figure  3.  That  each  portion  is  con- 
stricted into  three  pieces  is  proved  also  by 
watching  the  gradual  reduction  of  the  portion 
at  the  left  end  of  Hne  i  through  lines  2  and  3, 
and  also  in  the  gradual  formation  of  a  full-sized 
portion  at  the  right  end  of  lines  2,  3,  and  4. 
When  food  undergoing  this  process  is  watched, 
it  appears  to  be  affected  by  a  series  of  con- 
strictions, each  of  which  starts  at  one  end  of  the 
mass  and  marches  through  to  the  other  end, 
leaving  its  impress  at  short  intervals  along  the 
length.  The  progression  of  the  dotted  lines 
from  right  to  left  in  a,  b,  c,  and  d,  etc.,  Fig.  3, 
gives  a  notion  of  these  advancing  constrictions. 
Another  variation  of  the  segmentation  is 
shown  in  Figure  4.  In  this  type  there  are  evi- 
dently divisions  and  subdivisions,  i.  e.y  one  more 
operation  between  the  appearance  and  the  re- 
appearance of  the  same  phase  than  is  present  in 
the  simple  division  of  the  small  segments  in  a 
[351] 


^he  A.  B.-Z.  of  Our  Own  Nutrition 


long  string  of  food  (Fig.  2  ).  This  form  of 
segmentation  is  fairly  typical  for  the  constrictions 
seen  in  food  advancing  through  the  intestine. 
Sometimes  the  divisions  occur  in  the  middle  of 
a  long  string  of  food  and  leave  the  ends  wholly 
unaffected. 

A  remarkable  feature  in  the  segmentation  of 
he  food  is  the  rapidity  with  which  the  changes 

take  place. 
The  simplest 
way  of  estimat- 
ing the  rate  of 
division  is  to 
count,  not  the 
number  of 
times  the  parti- 
tion of  the  food 
recurs  in  the 
same  place, 
but  the  num- 
ber of  differ- 
ent sets  of  segments  observed  in  a  given  period. 
Thus  in  Figure  4  the  appearances  of  lines  i,  2, 
3,  4,  etc.,  would  be  counted,  and  not  merely  lines 
I,  4,  etc.  Repeated  observations  on  different 
animals  have  shown  that  the  most  common 
rate  of  division  in  long,  thin  chains  of  food 
varies  between  twenty-eight  and  thirty  times  in 
a  minute ;  /.  ^.,  there  is  a  change  from  one  set  of 
[352] 


Figure  3.  —  Diagram  showing  the  relations 
of  the  portions  when  they  are  constricted 
into  three  pieces.  The  dotted  lines  indi- 
cate regions  of  constriction ;  the  arrows  in- 
dicate the  relationship  of  the  pieces  to  the 
portions  they  subsequently  form. 


The  A.  B.'Z,of  Our  Own  Nutrition 

segments  to  another  set  every  two  seconds,  and 
a  return  of  the  same  phase  every  four  seconds. 
In  some  cases  the  rate  is  as  low  as  twenty-three 
times  per  minute.  The  larger  masses  seem  to 
be  associated  with  a  slower  segmentation;  the 
operations  indicated  in  Figure  3,  for  example, 
occurred  from  eighteen  to  twenty-one  times  in  a 
minute,  so  that  the  same  phase  reappeared  only 
once  in  eight  or  nine  seconds.  The  segmen- 
tation frequently  continues  for  more  than  half 
an  hour ;  in  one  instance  it  was  seen  to  persist 
with  only  three  short  periods  of  inactivity  for 
two  hours  and  twenty-two  minutes.  At  the 
rate  of  thirty  segmentations  per  minute  it  is 
clear  that  a  slender  string  of  food  may  com- 
monly undergo  division  into  small  particles 
more  than  a  thousand  times  while  scarcely 
changing  its  position  in  the  intestine. 

I  have  seen  once,  in  a  cat  only  lightly  ether- 
ised, the  exterior  of  an  intestine  which  was 
dividing  the  food  as  above  described.  An  hour 
and  a  half  after  a  meal  of  salmon  the  anaesthetic 
was  given,  the  abdomen  opened,  and  the  flaps 
raised  so  as  to  form  walls.  Warm  salt  solution 
was  then  poured  into  the  abdominal  cavity,  and 
the  floating  coils  left  covered  with  the  trans- 
parent omentum.  The  gastric  peristaltic  waves 
were  running  regularly;  on  the  intestine  there 
were  visible  at  various  places  during  the  period 

^3  [  353  ] 


The  A,B,-Z.  of  Our  Own  Nutrition 

of  observation  regions  of  constriction  which  had 
the  appearance  shown  in  Figure  3,  except  that 
the  rings  were  relatively  nearer  together.  New 
rings  of  constriction  took  place  on  the  same  side 
of  all  the  bulging  parts  at  the  margin  of  the 
constricted  portion  (^.dotted  Hues, Fig.  3).  As 
new  rings  occurred  the  old  relaxed,  but  appar- 
ently with  tardiness,  for  the  contents  gurgled  as 
if  forced  through  the  narrowed  lumen.  The 
constrictions  recurred  irregularly  and  at  much 
longer  intervals  than  in  the  normal  animal.  The 
contracted  rings  were  pale  and  bloodless. 

The  effect  of  the  process  of  rhythmic  seg- 
mentation proves  it  an  admirable  mechanism. 
The  food  over  and  over  again  is  brought  into 
closest  contact  with  the  intestinal  walls  by  the 
swift  kneading  movement  of  the  muscles. 
Thereby  not  only  is  the  undigested  food  inti- 
mately mixed  with  the  digestive  juices,  but  the 
digested  food  is  thoroughly  exposed  to  the  or- 
gans of  absorption.  Mall  has  shown  that  con- 
traction of  the  intestinal  wall  has  the  effect  of 
pumping  the  blood  from  the  submucous  venous 
plexus  into  the  radicles  of  the  superior  mese- 
teric  vein,  and  thus  materially  aids  the  intestinal 
circulation.  Moreover,  lacteals  loaded  with  fat 
will  in  a  few  moments  become  empty  unless 
the  intestine  is  slit  lengthwise,  so  that  the  mus- 
cles cannot  exert  compression.     The  rhythmic 

[  354  ] 


The  A.  B.-Z,of  Our  Own  Nutrition 

constrictions,  therefore,  both  propel  the  blood  in 
the  portal  circulation  and  act  like  a  heart  in  pro- 
moting the  flow  of  lymph  in  the  lacteals.  This 
single  movement  with  its  several  results  is  an  ex- 
cellent example  of  bodily  economy ;  the  repeated 
constrictions,  as  already  shown,  thoroughly  churn 
the  food  and  digestive  fluids  together,  and  also 
plunge  the  absorbing  mucosa  into  the  very 
midst  of  the  food  masses  :  but  not  only  are  the 
processes  of  digestion  and  absorption  favoured 
by  these  movements;  they  also,  by  compres- 
sion of  the  veins  and  lacteals  of  the  intestinal 
wall,  serve  to  deport  through  blood  and  lymph 
channels  the  digested  and  absorbed  material. 

Peristalsis}  —  The  phenomena  of  peristalsis 
and  segmentation  are  usually  combined  in  some 
manner  while  the  food  passes  through  the  small 
intestine.  Peristalsis  is  observed  normally  in 
two  forms :  as  a  slow  advancing  of  the  food  for 
a  short  distance  in  a  coil,  and  as  a  rapid  move- 
ment sweeping  the  food  without  pause  through 
several  turns  of  the  gut.     The  latter   form  is 

1  Without  the  possibility  of  seeing  the  relations  of  a  move- 
ment to  the  ends  of  the  intestine,  it  cannot  be  stated  absolutely 
whether  the  movement  is  peristaltic  or  antiperistaltic.  Such 
relations  can  be  seen  on  the  fluorescent  screen  only  near  the 
stomach  and  near  the  ileocaecal  valve.  The  evidence  that 
advancing  peristalsis  is  the  normal  movement  is  so  over- 
whelming that  I  have  assumed  that  when  food  is  moving 
in  loops  not  visibly  related  to  fixed  points  it  is  moving 
forward. 

[355] 


l^he  A,B.-Z,  of  Our  Own  Nutrition 

frequently  seen  when  the  food  is  carried  on  from 
the  duodenum ;  and  it  may  readily  be  produced 
in  other  parts  of  the  small  intestine  by  giving  an 
enema  of  soapsuds. 

When  a  mass  of  food  has  been  subjected  for 
some  time  to  the  segmenting  activity  of  the 
intestine,  the  separate  segments,  instead  of 
being  again  divided,  may  suddenly  begin  to 
move  slowly  along  the  loop  in  which  they  lie. 
^^^^  That    this    movement    is    not    a 

^"^      *      swinging  of  the  coil  as  a  whole, 
CXD    2      but  a  peristaltic  advance  of  sepa- 
m^  CO    3      ^^^^  rings  of  its  circular  muscula- 
ture, is  made  probable  by  the  fact 
"  ^-^  4      that  the  succeeding  segments  fol- 
FiGURK  4.— Dia-     low  along  the    same    path   their 
gram    showing     predecessors    have   taken.      The 

combined    pen-      ^ 

staisis  and  sag-     advance  of  the  little  pieces  may 
mentation.  continue  for  seven  or  eight  centi- 

metres, when  finally  the  front  piece  stops  or  meets 
other  food.  Then  all  the  succeeding  pieces  are 
swept  one  by  one  into  the  accumulating  mass, 
which  at  last  lies  stretched  along  the  intestine,  a 
solid  string  manifesting  no  sign  of  commotion. 

Another  form  of  slow  peristalsis  is  frequently 
observed  when  the  food  is  pushed  forward,  not 
in  small  divisions,  but  as  a  large  lump.  The 
relatively  long  string  of  food  is  first  crowded  into 
an  ovoid  form  as  the  forward  movement  begins, 

[356] 


l^he  A.B.'  Z.  of  Our  Own  Nutrition 

and  as  it  is  collecting  thus,  it  seems  at  the  last 
to  be  suddenly  formed  into  a  more  rounded 
ball,  as  if  the  mass  were  pulled  or  pushed  to- 
gether at  the  two  ends.  The  next  moment  it  is 
indented  in  the  middle  by  a  circular  constriction 
(as  shown  in  Fig.  4,  line  2),  which  spreads  it  in 
both  directions  along  the  loop.  The  trailing 
portion  (tf)  is  next  cut  in  two,  and  the  severed 
part  sometimes  flies  back  over  its  course  about 
a  centimetre.  Now  the  whole  mass  is  swept 
together  again  and  slightly  forward  as  shown  in 
line  4,  Fig.  4,  and  the  segmenting  process  is 
repeated.  At  stage  3,  Fig.  4,  a  constriction 
sometimes  appears  around  the  middle  of  the 
advanced  portion  (^).  Thus,  with  many  halts 
and  interruptions,  the  food  slowly  advances. 

A  slight  variation  of  the  movement  just  de- 
scribed is  observed  when  the  amount  of  food  is 
greater  and  extends  farther  along  the  intestine. 
Under  such  circumstances,  as  the  mass  moves  for- 
ward, constrictions  appear  just  in  front  of  the  rear 
end,  which  separate  it  from  the  main  body,  and 
cause  it  to  shoot  backward  sometimes  through 
the  distance  of  a  centimetre.  The  main  body 
meanwhile  is  not  disturbed.  No  sooner  has  the 
rear  section  been  shot  away  than  it  is  swept  for- 
ward again  into  union  with  the  rest  of  the  food, 
and  the  whole  mass  then  advances  until  another 
interfering  constriction  repeats  the  process. 
[357] 


The  A,B,-Z.  of  Our  Own  Nutrition 

Rhythmic  segmentation  and  the  pendulum 
movement.  —  There  is  little  doubt  that  the  seg- 
mentation of  the  food  which  I  have  seen  is  due 
to  an  activity  of  the  intestinal  musculature  simi- 
lar to  that  which  causes  the  so-called  pendulum 
movement.  This  activity,  as  already  noted,  is 
rhythmic,  and,  although  accounts  differ,  ana- 
lytical methods  prove  that  it  involves  both  the 
longitudinal  and  the  circular  layers  of  muscle. 
Observations  of  the  effect  of  the  rhythmic  con- 
tractions upon  the  food  show  that  the  action  of 
the  circular  fibres  is  most  prominent.  It  is 
probable,  however,  that  the  longitudinal  fibres 
also  play  an  important  part  in  the  process  of 
segmentation.  Examination  of  Figure  2  makes 
clear  that  in  line  2  the  regions  of  constriction 
appear  between  the  regions  of  constriction  in 
line  3 ;  before  c  can  be  formed,  therefore,  the 
constriction  between  a  and  b  must  relax.  Con- 
traction of  the  longitudinal  fibres  between  two 
segments  would  help  to  enlarge  the  constricted 
lumen  of  the  gut  It  seems  probable  that,  as 
the  constrictions  on  either  side  of  c  occur,  the 
longitudinal  fibres  between  them  contract;  al- 
most simultaneously  the  constriction  between 
a  and  b  relaxes,  and  the  two  particles  are  thus 
brought  swiftly  together.  A  similar  process 
naturally  would  take  place  for  each  of  the  shift- 
ing segments.  Thus  the  function  of  the  longi- 
[358] 


The  A.  B,-  Z.of  Our  Own  Nutrition 

tudinal  muscles  would  be  to  contract  between 
new  rings  of  constriction  and  thereby  aid  in 
relaxing  the  former  ring  between  them.  During 
my  one  observation  of  the  segmenting  process, 
as  seen  on  the  surface  of  the  intestine,  I  could 
not  be  sure  that  the  distance  between  neighbour- 
ing segments  was  shortened  as  the  constriction 
relaxed;  that  activity  of  the 
longitudinal  fibres  is  present, 
however,  is  indicated  by  obser-  g^ 
vations  of  Raiser  on  the  intes-       ° 

0 

tines  of  the  rabbit  and  the  cat.  <, 
Raiser  observed  the  outer  sur-  * 
face  of  the  coils,  and  describes  ^'i^g^'showi^g^Ie^ 
the    normal    movement    as    an  mentation  of 
,                             -11  chyme  in  the  duo- 
alternate  Contraction  and  relaxa-  denum.    This 

tion     of    single     divisions    of    the  and  other  trac- 

,  .       ,.       ,       /-I  1  ings  reduced  two- 

longitudmal    fibres;     he     notes       thirds, 
that  these  short  divisions  shift. 
But  whether  they  shift  in  alternation  with  the 
shifting  circular   constrictions,   as  seems    prob- 
able, is  an  interesting  point  not  yet  determined. 
Bayliss  and  Starling  state  that  the  swaying 
pendulum    movements    are    essentially    due   to 
peristaltic  waves  recurring  in   the  same  place 
and   running  rapidly  downward.     This  form  of 
the  movements  I  have  seen  only  once.     At  this 
time  about  90  c.c.  of  soapy  water  had  been  in- 
jected.    This  procedure  has  the  effect  of  exag- 
[359] 


The  A,  B,-Z,of  Our  Own  Nutrition 

gerating  in  every  particular  the  movements  of 
the  small  intestine.  In  this  instance  a  broad 
constriction  appeared  about  the  middle  of  a 
long  string  of  food  and  persisted  there  while 
it  spread  down  the  gut.  As  the  contraction 
spread,  the  gut  swayed  slowly  to  and  fro  before  it. 
Then  there  was  a  relaxation,  followed  by  a  re- 
currence of  the  constriction  in  the  same  place, 
a  spreading  of  the  contraction,  and  a  swinging 
of  the  loop  just  as  before.  This  phenomenon 
was  repeated  again  and  again,  till  finally  the 
string  was  divided  and  the  forward  piece  pushed 
through  a  tortuous  course  to  the  colon. 

The  course  of  the  food  in  the  small  intestine. 
—  Chyme  is  not  forced  from  the  stomach  by 
every  wave  that  passes  over  the  antrum,  but 
only  at  intervals.  When  the  pylorus  relaxes,  the 
food,  moved  towards  the  pylorus  under  consider- 
able pressure,  is  squirted  along  the  duodenum  for 
two  centimetres  or  more.  Careful  watching  of 
this  food  shows  that  usually  it  lies  for  some  time 
in  the  curve  of  the  duodenum  until  additions  have 
been  made  to  it  from  the  stomach,  and  a  long, 
thin  string  of  food  is  formed.  While  it  is  rest- 
ing in  this  place  it  is  exposed  to  the  outpouring 
of  the  bile  and  pancreatic  juices.  All  at  once 
the  string  becomes  segmented  (see  Fig.  5)  and 
the  process  of  rhythmic  segmentation  continues 
several   minutes,  thoroughly  mixing  the  intes- 

[360] 


'The  A,  B,-Z,of  Our  Own  Nutrition 

tinal  digestive  juices  with  the  chyme.  In  this 
region  the  alternate  positions  of  the  segments 
are  sometimes  far  apart,  and  the  to-and-fro 
movements  of  the  particles  may  be  a  relatively 
extensive  and  very  energetic  swinging.  Finally 
the  little  segments  unite  into  a  single  mass,  or 
form  in  groups,  and  begin  to  move  forward. 
The  peristalsis  here,  as  already  mentioned,  is 
much  more  rapid  than  the  normal  peristalsis 
elsewhere  in  the  small  intestine.  The  masses, 
once  started,  go  flying  along,  turning  curves, 
whisking  hither  and  thither  in  the  loops,  moving 
swiftly  and  continuously  forward.  After  pass- 
ing on  in  this  rapid  manner  for  some  distance 
the  food  is  collected  in  thicker  and  longer  strings, 
resembling  the  strings  seen  characteristically  in 
the  other  loops.  Towards  the  end  of  digestion 
the  small  masses  shot  out  from  the  stomach, 
after  a  few  segmentations,  may  move  on  in  the 
rapid  course  without  being  accumulated  in  a 
larger  mass  until  the  swift  movement  ceases. 

During  the  first  stages  of  digestion  in  the 
cat's  small  intestine  the  food  usually  lies  chiefly 
on  the  right  side  of  the  abdomen ;  during  the 
last  stages  the  loops  on  the  left  side  contain 
the  greater  amount  of  food.  In  these  loops 
the  food  remains  sometimes  for  an  hour  or  more 
with  no  sign  of  movement.  All  at  once  a  mass 
begins  to  show  irregular  depressions  and  eleva- 

[361] 


The  A,B,-Z,  of  Our  Own  Nutrition 

tions  along  its  length,  and  then  suddenly  it  is 
divided,  at  first  partially,  later  completely,  into 
many  little  equal  parts,  and  these  repeatedly 
undergo  division  and  reunion,  division  and  re- 
union, over  and  over  again,  in  the  manner 
described  above  as  rhythmic  segmentation. 
After  a  varying  length  of  time  the  activity 
wanes  and  the  little  segments  are  carried  for- 
ward individually  and  later  brought  together, 
or  join  and  move  on  as  a  single  body,  or  they 
may  reunite  and  lie  quietly  for  some  time  with- 
out further  change.  Thus  by  a  combined 
process  of  kneading  and  peristaltic  advance  the 
food  is  brought  to  the  ileocaecal  valve  to  enter 
the  large  intestine.  Records  from  ten  different 
animals  show  that  salmon  does  not  appear  in 
the  small  intestine  until  an  hour  or  an  hour  and 
a  half  after  the  food  is  eaten.  Inasmuch  as  five 
or  six  hours  elapse  after  eating  before  this  food 
begins  to  be  seen  in  the  colon,  it  is  evident  that 
the  chyme  takes  four  to  five  hours  to  pass  the 
length  of  the  small  intestine.  It  is  interesting 
to  note  that  the  operations  are  considerably 
shortened  if  the  meal  has  consisted  of  bread  and 
milk. 

The  Competence  of  the  Ileocecal  Valve 

The  ileocaecal   valve  in  the  cat  is  situated 
three  or  four  centimetres  from  the  blind  end  of 
[362] 


7 he  A.  B.-Z,of  Our  Own  Nutrition 

the  caecum.  Its  position  is  usually  marked  in 
shadows  of  the  food  in  the  colon  by  a  slight 
indentation,  towards  which  masses  about  to  enter 
the  colon  are  ordinarily  directed  from  a  point 
somewhat  distant  in  the  small  intestine  (see 
Fig.  6). 

Regarding  the  competence  of  the  ileocaecal 
valve  many  observations  have  been  made. 
Griitzner  has  reviewed  the  evidence  bearing  on 
the  question  and  concludes  that  the  valve  is  not 
competent,  least  of  all  for  liquids.  He  declares 
that  as  soon  as  liquids  or  thin  fluid  masses  ap- 
pear in  the  upper  part  of  the  colon  they  pass 
in  many  instances  into  the  small  intestine  the 
moment  that  the  pressure  on  the  colon  side 
rises  slightly.  If  the  colon  contains  a  solid  or 
a  thick,  mushy  mass,  the  passage  towards  the 
small  intestine  is  scarcely  possible,  because 
every  increase  of  pressure  in  the  large  intestine 
must  force  the  two  lips  of  the  valve  together 
and  close  it. 

The  importance  of  the  competence  of  the 
ileocaecal  valve  under  normal  conditions  cannot 
be  appreciated  until  the  function  of  the  first 
part  of  the  colon  is  considered.  In  order  that 
this  part  of  the  intestinal  mechanism  may  per- 
form its  service,  the  competence  of  the  valve 
for  the  food  which  enters  the  colon  from  the 
ileum  should  be  perfect.     As  a  matter  of  fact, 

[363] 


The  A,  B.-Z,  of  Our  Own  Nutrition 

such  is  the  case.  Not  only  does  the  activity  of 
the  colon  prove  this  statement,  but  the  failure 
of  every  attempt  to  drive  the  food  in  the  colon 
back  through  the  valve  into  the  ileum  confirms 
the  proof.  Again  and  again  I  have  tried,  by 
manipulation  through  the  abdominal  wall,  to 
press  the  normal  contents  of  the  colon  down- 
ward with  sufficient  force  to  cause  them  to  re- 
turn to  the  small  intestine,  but  without  success. 
The  valve  held  perfectly. 

The  Movements  of  the  Large  Intestine 

When  the  large  intestine  is  full,  palpation 
through  the  abdominal  wall  demonstrates  that 
the  material  in  the  lower  descending  colon  and 
in  the  sigmoid  flexure  is  usually  composed  of 
hard,  incompressible  lumps,  while  that  in  the 
ascending  and  transverse  colon  and  the  caecum 
is  soft,  permitting  the  walls  of  the  gut  to  be 
easily  pushed  together.  The  condition  of  the 
contents  in  these  two  regions  seems  to  indicate 
a  rough  division  of  the  large  intestine  into  two 
parts,  and  the  mechanical  activities  of  these  two 
parts  verify  the  differentiation.  In  the  descend- 
ing colon  the  material  is  very  slowly  advanced 
by  rings  of  tonic  constrictions  (see  Fig.  7) ;  in 
the  ascending  and  transverse  colon  and  in  the 
caecum  by  far  the  most  common  movement  is 
an  antiperistalsis. 

[364] 


T^he  A.  B.-Z.of  Our  Own  Nutrition 

Antiperistalsis  in  the  colon. — The  colon  of 
cats  which  have  been  without  food  for  a  day 
usually  contains  enough  gas  to  make  the  posi- 
tion of  the  gut  distinguishable  with  the  fluores- 
cent screen  (see  Fig.  i).  The  first  food  to 
enter  the  colon  from  the  small  intestine  is  car- 
ried by  antiperistaltic  waves  into  the  caecum 
(Fig.  i),  and  all  new  food  as  it  enters  is  also 
affected  by  these  waves.  Thus  the  contents  of 
the  colon,  instead  of  being  driven  immediately 
toward  the  rectum  by  slow  peristalsis,  as  is  the 
general  opinion,  are  first  repeatedly  pushed 
toward  the  caecum  by  an  antiperistaltic  action. 

These  antiperistaltic  waves  follow  one  after 
another  like  the  peristaltic  waves  of  the  stomach 
(see  Figs.  5,  6,  and  10).  They  begin  either  on 
the  more  advanced  portion  of  the  food  in  the 
colon  (when  only  a  small  amoimt  is  present),  or 
at  the  nearest  tonic  constriction,  which  is  usually 
at  the  turn  between  the  transverse  and  descend- 
ing colon  (Figs.  7  and  8.)  The  waves  rarely 
run  continuously  for  a  long  time.  When  the 
colon  is  full,  it  is  usually  quiet.  The  first  sign 
of  activity  is  an  irregular  undulation  of  the 
walls,  then  very  faint  constrictions  passing  along 
the  gut  towards  the  caecum.  These  constrictions 
may  first  appear  only  on  the  ascending  colon. 
As  they  continue  coursing  over  the  intestine 
they  become  deeper  and  deeper,  until  there  is 

[365] 


The  A,B,'Z.  of  Our  Own  Nutrition 

a  marked  bulging  between  successive  constric- 
tions. When  the  waves  have  thus  become 
more  prominent,  they  are  seen  to  start  near  the 
end  of  the  transverse  colon  and  pass  without 
interruption  to  the  end  of  the  caecum.  After 
these  deepest  waves  have  been  running  for  a 
few  minutes  the  indentations  grow  gradually 
less  marked,  until  at  last  they  are  so  faint  as  to 
be  hardly  discernible.  The  final  waves  are 
sometimes  to  be  observed  only  at  the  end  of 
the  transverse  colon. 

Such  a  period  of  antiperistalsis  lasts  from 
two  to  eight  minutes,  with  an  average  duration 
of  four  or  five  minutes.  The  periods  recur  at 
varying  lengths  of  time ;  in  one  instance  a  period 
began  at  1.38  P.M.  and  was  repeated  at  2.06, 
2.34,  2.55,  3.15,  and  at  3.36,  when  the  obser- 
vation ceased;  in  another  instance  a  period 
began  at  2.43  P.M.,  and  was  repeated  at  2.57 
and  at  intervals  of  from  ten  to  fifteen  minutes 
thereafter  while  the  animal  was  being  watched. 
The  waves  have  nearly  the  same  rate  of  recur- 
rence as  those  in  the  stomach ;  about  five  and 
a  half  waves  pass  a  given  point  in  a  minute,  i.  e.y 
eleven  waves  in  two  minutes.  This  rate  has 
proved  fairly  constant  in  different  cats  and  at 
different  stages  in  the  process  of  digestion ;  in 
one  case,  however,  the  waves  passed  at  the  rate 
of  nine  in  two  minutes. 

[366] 


T^he  A,B,'Z.  of  Our  Own  Nutrition 

The  stimulating  effect  of  rectal  injections  on 
the  movements  of  the  small  intestine  has  already 
been  noted.  Enemata  have  also  pronounced 
stimulating  action  on  the  antiperistalsis  of  the 
colon.  Usually  the  almost  immediate  result  of 
a  rectal  injection  of  warm  water  is  the  appear- 
ance of  deep  antiperistaltic  waves,  which  often 
continue  running  for  a  long  period.  In  one 
case,  after  an  injection  of  50  ex.  of  warm  water, 
the  waves  followed  one  another  with  monoto- 
nous regularity  during  an  observation  lasting 
an  hour  and  twenty  minutes.  The  manner  in 
which  this  antiperistaltic  mechanism  affects 
nutrient  enemata  introduced  into  the  bowel  will 
be  discussed  in  the  section  devoted  to  the 
question  of  antiperistalsis. 

These  constrictions  passing  backward  over 
the  colon  do  not  force  the  normal  contents 
back  through  the  valve  into  the  small  intestine 
again.  I  have  seen  hundreds  of  such  constric- 
tions, and  only  twice  have  there  been  exceptions 
to  this  rule, — once  under  normal  conditions, 
when  a  small  mass  slipped  back  into  the  ileum, 
and  at  another  time  when  a  large  amount  of 
water  had  been  introduced  into  the  colon.  The 
importance  of  the  competence  of  the  ileocaecal 
valve  is  now  apparent;  indeed,  antiperistalsis 
in  the  colon  gives  new  meaning  and  value  to  the 
location  of  a  valve  at  the  opening  of  the  ileum. 
[367] 


The  A,  B,-Z.of  Our  Own  Nutrition 

For,  inasmuch  as  the  valve  is  normally  com- 
petent, the  constrictions  repeatedly  coursing 
towards  it  force  the  food  before  them  into  a  blind 
sac.  The  effect  on  the  food  must  be  the  same 
as  the  effect  seen  in  the  stomach  when  the 
pylorus  remains  closed  before  the  advancing 
waves.  The  food  is  pressed  forward  by  the 
approach  of  each  constriction  ;  but  since  it  can- 
not go  onward  in  the  blind  sac,  and  is,  more- 
over, subjected  to  increasing  pressure  as  the 
constriction  comes  nearer,  it  is  forced  into  the 
only  way  of  escape,  i.  e.y  away  from  the  caecum 
through  the  advancing  constricted  ring.  About 
twenty-five  waves  affect  every  particle  of  food 
in  the  colon  in  this  manner  during  each  normal 
period  of  antiperistalsis.  The  result  must  be 
again  a  thorough  mixing  of  the  contents  and  a 
bringing  of  these  contents  into  close  contact 
with  the  absorbing  wall  —  a  process  which  has 
already  been  variously  repeated  many  times  in 
the  stomach  and  in  the  small  intestine. 

Two  other  movements  have  been  observed 
in  the  ascending  colon,  but  they  are  rare  ap- 
pearances. The  first  of  these  was  a  serial  sec- 
tioning of  the  contents  noticed  in  an  animal 
given  castor  oil  with  the  food.  A  constriction 
separated  a  small  segment  in  the  caecum;  an- 
other constriction  then  cut  off  a  segment  just 
above  the  first,  and  with  the  disappearance  of 
[368] 


T^he  A,  B.-Z,of  Our  Own  Nutrition 

the  first  constriction  the  two  separated  seg- 
ments united.  A  third  segmentation  took  place 
above  the  second,  and  the  changes  occurred 
again.  Thus  the  whole  mass  was  sectioned 
from  one  end  to  the  other ;  and  no  sooner  was 
that  finished  than  the  process  began  again  and 
was  repeated  several  times.  A  slight  modifica- 
tion of  this  movement  was  observed  in  a  colon 
containing  very  little  food.  The  mass  was 
pressed  and  partially  segmented  in  the  manner 
characteristic  of  the  small  intestine,  and  was 
thus  again  and  again  spread  along  the  ascend- 
ing colon,  and  each  time  swept  back  into  a 
rounded  form  by  antiperistalsis.  The  second 
of  the  two  movements  mentioned  above  con- 
sisted in  a  gentle  kneading  of  the  contents. 
This  was  caused  by  broad  constrictions  appear- 
ing, relaxing,  appearing,  relaxing,  over  and 
over  again,  in  the  same  place.  When  several  of 
these  regions  were  active  at  the  same  time, 
they  gave  the  food  in  the  colon  the  appearance 
of  a  restless  undulatory  mass.  Once  a  constric- 
tion occurred  and  remained  permanently  in  one 
place,  while  the  bulging  parts  on  either  side  of 
it  pulsated  alternately,  at  the  rate  of  about 
eighteen  times  in  a  minute,  with  the  regularity 
of  the  heart-beat.  Although  these  phenomena 
are  somewhat  striking,  they  are  not  usual,  and 
are  in  no  way  so  important  as  the  antiperistalsis. 
24  [  369  ] 


The  A.B,-Z,  of  Our  Own  Nutrition 

The  changes  when  food  enters  the  colon,  — 
The  passage  of  food  through  the  ileocaecal 
valve  seems  to  stimulate  the  colon  to  activity. 
As  food  is  nearing  the  ileocaecal  valve  the  large 
intestine  is  usually  quiet  and  relaxed  (Fig.  6, 
4.00),  though  occasionally  indefinite  movements 
are  to  be  observed ;  and  sometimes  just  before 
the  food  reaches  the  end  of  the  ileum  the  cir- 
cular fibres  of  the  colon  in  the  region  of  the 
valve  contract  strongly,  so  that  a  deep  inden- 
tation is  present  there.  The  indentation  may 
persist  several  minutes;  it  disappears  as  the 
muscles  relax  just  previous  to  the  entrance  of 
the  food.  The  food  is  moved  slowly  along  the 
ileum  and  is  pushed  through  the  valve  into  the 
colon.  The  moment  it  has  entered  a  strong 
contraction  takes  place  all  along  the  caecum  and 
the  beginning  of  the  ascending  colon,  pressing 
some  of  the  food  onward,  and  a  moment  later 
deep  antiperistaltic  waves  (Fig.  6,  4.03)  sweep 
down  from  the  transverse  colon  and  continue 
running  until  the  caecum  is  again  normally  full, 
i.  e.y  for  two  or  three  minutes. 

The  appearance  of  tonic  constrictions.  —  It  has 
already  been  noted  that  as  the  food  accumulates 
in  the  ascending  colon  it  is  at  first  confined  to 
this  region  by  antiperistaltic  waves.  With  fur- 
ther accessions,  however,  the  contents  naturally 
must  be  pressed  more  and  more  into  the  trans- 
[370] 


The  A,  B,-Z.of  Our  Own  Nutrition 


verse  and  descending  colon.  In  the  early  stages 
of  this  accumulation,  while  the  food  lies  chiefly 
in  the  ascending  colon,  the  only  activity  of  the 
muscular  walls  is  the  antiperistalsis.  As  the 
contents  extend  along  the  intestine  a  deep  con- 
striction appears  near  the  advancing  end  and 
nearly  separates  a  globular  mass  from  the  main 
body  of  the  food  (Fig.  6).  The  contents  of  the 
large  intestine  pro- 
gress farther  and 
farther  from  the 
caecum ;  meanwhile 
new  tonic  constric- 
tions appear  which 
separate  the  con- 
tents into  a  series 
of  globular  masses. 
And  as  the  number 
of  these  divisions  in- 
creases they  take  a 
position  farther  from  the  caecum,  so  that  they  are 
present  chiefly  in  the  descending  colon  (Fig.  7  ). 
Raiser  has  recorded  a  similar  appearance  in  the 
terminal  portion  of  the  rabbit's  colon,  in  which 
deep  circular  constrictions  separate  the  scyba- 
lous masses.  He  maintains  that  these  masses  are 
pushed  onward  by  the  constrictions.  Compar- 
ing tracings  made  at  rather  long  intervals  forty- 
five  minutes),  I  found  that  the  rings  disappear 

[371] 


Figure  6.  —  Tracings  showing 
changes  when  food  enters  the  colon 
and  also  the  first  tonic  constriction. 
4.00,  the  colon  relaxed  as  food  ap- 
proaches in  the  ileum.  4.03,  the 
colon  contracted  and  traversed  by 
antiperistaltic  waves  after  the  food 
has  entered. 


The  A.  B.-Z.  of  Our  Own  Nutrition 


from  the  transverse  colon,  and  then  are  present 
with  the  waste  material  in  the  descending  colon. 
Thus  in  the  cat  also  these  rings,  which  seem  with 
short  observation  to  be  remaining  in  one  posi- 
tion, are  in  reality  moving  slowly  away  from  the 
caecum,  pushing  the  hard- 
ening contents  before 
them.  The  contents  at 
this  stage  are  no  longer 
fluid,  and  consequently 
they  must  offer  consider- 
able resistance  to  a  force 
pushing  them  through  the 
colon.  It  is  an  advantage 
to  have  this  pultaceous 
substance  propelled  in 
divisions  rather  than  in 
a  uniformly  cylindrical 
mass,  since  the  fibre 
along  the  length  of  th(. 
mass  are  thereby  ren- 
dered effective.  Such  are 
the  functions  of  the  per- 
sistent rings ;  they  form  the  waste  matter  into 
globular  masses  at  the  end  of  the  transverse 
colon  and  slowly  push  these  masses  onward. 

In  the  transverse  colon,  which  is  free  from 
the    slowly    moving    rings,    the    antiperistaltic 
waves   have    full    sway.     In   the   region   of  the 
[372] 


Figure  7. —  Radiograph 
showing  the  region  of  tonic 
constrictions  (descending 
colon)  and  the  region  of 
antiperistalsis  (transverse 
and   ascending   colon). 


The  A.B.'Z,  of  Our  Own  Nutrition 

tonic  rings  an  infrequent  or  even  a  slowly  peri- 
odic relaxation  and  contraction  are  often  to  be 
observed.  These  changes  seem  to  take  place 
in  all  the  rings  at  about  the  same  time.  Once 
I  saw  antiperistaltic  waves  running  over  the 
,  uppermost  of  four  segments,  but  since  the 
rings  on  either  side  of  the  segment  held  tightly, 
the  waves  had  merely  the  effect  of  churning  the 
material  of  the  segment  and  did  not  move  it 
onward.  Inasmuch  as  the  material  in  these 
segments  at  first  is  soft,  so  that  the  segments 
are  easily  compressible,  while  the  faecal  masses 
which  are  the  final  result  are  relatively  hard  and 
dry,  it  follows  that  even  within  the  confines  of 
these  persistent  rings  some  absorption  is  taking 
place. 

Defecation 

The  process  of  clearing  the  colon  is  a  proc- 
ess of  repeated  reduction  of  the  amount  of 
material  present.  Figure  8  (3.1 1)  is  a  radio- 
graph showing  the  food  in  the  colon  at  3.1 1  P.M. 
About  3.25,  with  a  slow,  sweeping  movement, 
the  gut  swung  around  so  that  the  ascending 
colon  was  lying  in  the  position  of  the  last  half 
of  the  transverse  colon,  and  the  transverse  colon 
had  taken  the  position  of  the  descending  part 
(Fig.  8,  3.25).  At  the  same  time  the  tonic  con- 
strictions disappeared  and  were  replaced  by  a 
strong,  broad  contraction  of  the  circular  mus- 
[373] 


The  A.  B,-Z.  of  Our  Own  Nutrition 

cle,  tapering  the  contents  off  on  either  side  in 
two  cones.  The  region  of  strongest  contraction 
was  apparently  drawn  downward  with  the  rest 
of  the  gut  by  a  shortening  of  the  descending 
colon.  As  the  intestine  swung  around,  more 
material  was  forced  into  the  rectum,  and  when 
the  swinging  of  the  intestine  stopped,  the  con- 
striction which  divided  the  lumen  passed  slowly 
downward,  and  with  the  aid  of  the  muscles  sur- 
rounding the  abdominal  cavity,  pushed  the  sepa- 
rated mass  out  of  the  canal.^  After  the  terminal 
mass  had  thus  been  pushed  out,  the  colon  with 
the  remainder  of  its  contents  returned  to  nearly 
its  former  position  (Fig.  8,  3.46).  About  two 
hours  afterward  this  remnant  had  been  spread 
throughout  the  length  of  the  large  intestine  by 
means  of  the  slowly  moving  rings.  Figure  7  is  a 
radiograph  of  the  same  colon  pictured  in  Figure 
8;  the  radiograph  was  taken  at  11.50  A.M.,  and 
at  12.15  P.M.  the  material  in  the  lower  descend- 
ing colon  was  forced  out  in  the  manner  above 
described.  Within  three  hours  the  remaining 
portion  had  been  spread  into  the  evacuated  re- 
gion, as  shown  in  Figure  8,  3.1 1.  The  manner 
in  which  the  material  is  spread  from  the  region 
of  the  antiperistaltic  waves  into  the  region  of 
the  slowly  advancing  rings  presents  a  problem. 
During  normal  living  new  food  constantly  ar- 
1  In  this  case  the  faeces  were  soft. 

[374] 


T^he  A,  B.-Z.of  Our  Own  Nutrition 

riving  in  the  colon  must  force  the  old  contents 
forward  just  as  the  later  parts  of  a  meal  force 
forward   the   earlier   parts;    there  is  no  doubt, 


a.  rt  o 
m'S  *" 

e    J3    !" 
.5    d    C 

^   >   b 
5  5- 

m     O     U, 

^-^  § 


I  "J 


rt  i^         o 
o  S  iJ  o 


1 1  i  =• 

o .  -  


however,  that  most  of  the  contents  of  the 
caecum  and  the  ascending  colon  may  be  passed 
onward  even  during  starvation.     The  emptying 

[375] 


'The  A,  B.-  Z.of  Our  Own  Nutrition 

of  these  regions,  according  to  my  observations, 
is  never  complete ;  for  after  considerable  time 
has  elapsed  and  the  large  intestine  is  cleared 
and  dilated  with  gas,  some  substance  is  still 
to  be  detected  in  the  caecum  and  clinging  to 
the  walls  of  the  ascending  colon.  The  only 
activities  manifested  here  are  the  antiperistaltic 
waves  and  the  strong  tonic  contraction  of  the 
whole  circular  musculature  shown  in  Figure  6. 
It  is  clear  that  the  latter  activity  would  serve  to 
press  into  the  transverse  colon  a  considerable 
portion  of  the  contents  of  the  ascending  colon, 
and  the  remnant  seen  clinging  to  the  walls  would 
be  the  part  not  thus  pressed  forward. 

Twice  I  have  seen  appearances  which  might 
account  for  the  emptying  of  the  first  portion  of 
the  large  intestine  in  a  more  thorough  manner 
than  that  above  described.  At  one  time,  with- 
out apparent  stimulation,  strong  tonic  contrac- 
tion occurred  along  the  entire  length  of  the 
ascending  colon,  which  forced  the  contents  al- 
most wholly  into  the  transverse  portion.  This 
action  seemed  merely  an  exaggerated  form  of 
that  observable  after  food  passes  the  ileocaecal 
valve  (see  Fig.  6).  At  another  time,  after  a 
mass  of  food  had  passed  through  the  ileocaecal 
valve,  after  the  ascending  colon  had  contracted 
generally  and  the  antiperistaltic  waves  had 
coursed    over   it   in    the  usual  manner,  a  deep 

[376] 


The  A.B.-Z,  of  Our  Own  Nutrition 

constriction  appeared  at  the  valve  and  ran  up- 
ward without  relaxation  nearly  the  length  of  the 
ascending  colon,  pushing  the  contents  before  it. 
For  an  instant  the  wave  paused ;  then  the  con- 
striction relaxed  and  the  food  returned  towards 
the  caecum.  These  observations  indicate  that 
either  a  general  contraction  of  the  wall  of  the 
large  intestine  or  a  true  peristalsis  may  be  effec- 
tive in  pressing  waste  matter  from  the  region 
where  antiperistalsis  is  the  usual  activity  into  the 
region  where  the  slowly  advancing  rings  may 
carry  it  on  to  evacuation    (see  Fig.  7). 

The  Question  of  Antiperistalsis 

In  1894  Griitzner  published  an  observation 
and  made  an  assumption  about  which  there  has 
since  been  much  controversy.  He  maintained 
that  when  normal  salt  solution,  holding  in  sus- 
pension hair,  powdered  charcoal,  or  starch 
grains,  is  injected  into  the  rectum,  it  is  carried 
upward  into  the  small  intestine  and  may  even 
enter  the  stomach.  These  experiments  have 
been  repeated  by  several  obser\^ers.  Some 
have  confirmed  Griitzner's  results ;  others  have 
failed,  after  using  most  careful  methods,  to  find 
any  evidence  of  the  passage  of  the  injected 
material  back  to  the  stomach,  and  they  have 
declared  that  the  apparent  success  was  due  to 
carelessly  allowing  the  food  of  the  animal  to 
[377] 


I'he  A,  B.-Z.of  Our  Own  Nutrition 

become  contaminated  with  the  test  materials,  so 
that  these  were  introduced  into  the  stomach 
by  way  of  the  mouth.  That  antiperistalsis  does 
not  occur  in  the  small  intestine  seems  to  be 
proved  by  Mall's  experiment  of  reversing  a 
portion,  sewing  it  in  place,  and  then  finding  that 
the  food  does  not  pass  the  reversed  region,  but 
collects  at  the  upper  end.  Sabbatani  and  Fasola 
reversed  stretches  of  small  intestine  of  varying 
length,  and  found  that  the  reversed  portions 
allowed  fluids  to  pass,  but  that  the  persistence 
of  the  physiological  direction  of  movement 
caused  an  accumulation  of  undigested  food  in 
the  region  of  the  upper  suture.  However  a 
portion  of  the  intestine  lay  in  relation  to  the 
rest,  it  always  manifested  the  normal  peristal- 
sis. Many  other  observers  working  directly  on 
the  intestine  confirm  this  testimony  and  state 
that  the  progress  of  the  constriction-rings  is 
always  downward,  and  that  antiperistalsis  is  not 
physiological.  In  1898,  however,  Griitzner  took 
his  stand  again  in  favour  of  a  backward  move- 
ment in  the  intestines,  and  in  a  somewhat  meta- 
physical manner  argued  that  peristalsis  and 
antiperistalsis  belong  to  each  other  just  as  re- 
laxation of  muscle  is  related  to  contraction.  He 
assumed  that  as  the  contents  are  advanced  by 
slow  peristalsis,  so  are  they  returned  by  a  simi- 
lar movement  in  the  opposite  direction,  and  he 

[378] 


The  A,  B.-Z.of  Our  Own  Nutrition 

mentions  several  pathological  cases  (fistula  of 
intestine)  to  substantiate  the  assumption. 

By  means  of  the  X-rays  it  is  possible  to  see 
just  what  takes  place  when  a  fluid  is  injected 
into  the  rectum.  For  the  purpose  of  determin- 
ing how  nutrient  enemata  are  received  and  acted 
upon  in  the  intestines,  I  have  introduced  thin, 
fluid  masses  in  large  and  small  amounts,  and 
thick,  mushy  masses  in  large  and  small  amounts, 
in  different  animals.  The  enemata  consisted  of 
lOO  c.c.  of  milk,  one  Qggy  ten  to  fifteen  grams 
of  bismuth  subnitrate,  and  two  grams  of  starch 
to  hold  the  bismuth  powder  in  suspension.  To 
make  the  thick  enema  all  these  were  stirred 
together  and  boiled  to  a  soft  mush  ;  to  make  the 
thin  enema  all  the  parts  were  boiled  together 
except  the  Qgg,  which  was  added  after  the  boiled 
portion  was  cooled.  The  small  amount  injected 
was  25  c.c;  the  large  amount  almost  90  c.c, 
about  the  capacity  of  the  large  intestine  when 
removed  from  the  body.  The  animals  were 
given  first  a  cleansing  injection,  and  after  this 
was  effective  the  nutrient  material  was  intro- 
duced. In  order  to  make  sure  of  the  observa- 
tion, a  control  radiograph  was  first  taken  to 
show  no  bismuth  food  present,  and  other  radio- 
graphs taken  at  varying  intervals  after  the  injec- 
tion to  record  the  course  the  food  was  following. 

These  experiments  show  that  when  small 
[379] 


'The  A,  B,-Z,  of  Our  Own  Nutrition 


C  73 


o 

f5 

a 

g 

"^ 

V 

^ 

o 

H 

^ 

rt 

rt 

to 

a, 

fc 

o^ 

-i-> 

.— 

>, 

rt 

p 

rt 

C 

C 

(U 

•:;3 

ba 

rt 

o 
c 

3 

O 

£ 

S 

1/3 

C 

C) 

05 

o 

br 

fo 

.S:! 

D 

-% 

O 

<; 

X 

c 

1 

7. 

s 

Hi 

w 

vii 

o 

—1 

<fl 

M 

[380 


T^he  A,  B.-Z.of  Our  Own  Nutrition 

amounts  of  nutrient  fluid  are  introduced  they 
lie  first  in  the  descending  colon.  In  every  in- 
stance antiperistaltic  waves  are  set  going  by  the 
injection,  and  the  material  is  thereby  carried  to 
the  caecum.  When  large  amounts  are  injected 
they  stop  for  a  moment  in  the  region  between 
the  transverse  and  descending  colon,  as  if  a 
constriction  existed  there.  Then  a  considerable 
amount  of  the  fluid  passes  the  point,  and  anti- 
peristaltic waves  carry  it  to  the  caecum.  In  any 
case  the  repeated  passing  of  the  waves  seems  to 
have  the  efl"ect  of  promoting  absorption,  for  in 
the  region  where  these  waves  continue  running, 
the  shadows  become  gradually  more  dim,  and 
finally  the  bismuth  appears  to  be  only  on  the  in- 
testinal walls;  in  other  regions,  e.g.  in  the  de- 
scending colon,  the  shadows  retain  their  original 
intensity.  Small  injections  have  never  in  my 
experience  been  forced  even  in  part  into  the 
small  intestine ;  but  with  the  larger  amounts, 
whether  fluid  or  mushy,  the  radiographs  show 
many  coils  of  the  small  intestine  containing  the 
bismuth   food. 

The  passage  of  the  injected  material  beyond 
the  ileocaecal  valve  is  probably  due  entirely  to 
antiperistalsis  in  the  colon,  —  a  factor  unknown 
to  both  Griitzner  and  his  opponents.  The  valve, 
which  is  thoroughly  competent  for  food  coming 
normally  from  the  small  intestine  into  the  large, 
[38-] 


The  A.  B.-Z,  of  Our  Own  Nutrition 

is  curiously  incompetent  for  a  substance,  even 
of  the  consistency  of  thick  cream,  introduced 
in  large  amount  by  rectum.  When  the  valve 
first  permits  the  food  to  enter  the  ileum,  the 
fluid  pours  through  and  appears  suddenly  as 
a  winding  mass  occupying  several  loops  of  the 
intestine  (Fig.  9,  1.50,  about  ten  minutes  after 
the  injection).  The  mass  is  continuous  from 
the  valve  to  the  other  end ;  antiperistalsis  is 
therefore  not  visible  in  the  small  intestine  under 
the  circumstances  of  this  experiment.  The 
antiperistaltic  waves  of  the  colon,  however,  con- 
tinue running;  the  transverse  and  ascending 
colon  are  thus  almost  emptied,  and  the  small  in- 
testine more  and  more  filled  with  food  (Fig,  9, 
2.15  and  3.00).  After  a  short  time  the  typical 
segmenting  movements  can  be  seen  in  the  loops, 
busily  separating  the  food  into  small  masses, 
and  over  and  over  again  dividing  and  redividing 
them. 

I  have  never  seen  food  material  pass  back 
from  the  colon  so  far  as  the  stomach ;  but  once, 
about  ten  minutes  after  an  injection  of  100  c.c. 
of  warm  water,  the  cat  retched  and  vomited  a 
clear  fluid  resembling  mixed  water  and  mucus. 
In  the  fluid  were  two  intestinal  worms  still  afive. 

The  importance  of  the  mechanism  by  which 
nutrient  enemata  are  passed  backward  in  the 
intestine  is  evident.     In  the  colon  the  nutrient 

[382] 


i:he  A.B,'Z,  of  Our  Own  Nutrition 

material  is  worked  over  by  the  antiperistaltic 
waves,  intimately  mixed  with  whatever  digestive 
juices  may  be  present,  and  exposed  to  the 
organs  of  absorption  in  that  region.  If  the  ene- 
mata  are  large,  the  digestive  and  absorptive 
processes  are  by  no  means  confined  to  the 
colon,  but  may  take  place  along  extensive  sur- 
faces of  the  small  intestine.  I  have  repeatedly 
seen  rhythmic  segmentation  active  throughout 
many  loops  of  the  small  intestine,  thus  expos- 
ing the  injected  food  to  the  same  mixing  and  ab- 
sorbing processes  as  affect  the  nutriment  which 
has  come  through  the  stomach  in  a  normal 
manner. 

The  Effect  of  Emotions  and  Sleep 

Observations  on  the  stomach  of  the  cat 
showed  that  the  peristalsis  is  inhibited  when- 
ever the  animal  manifests  signs  of  anxiety,  rage, 
or  distress.  Since  the  extrinsic  innervation  of  a 
large  part  of  the  intestinal  tract  is  the  same  as 
that  of  the  stomach,  it  is  of  interest  to  note  the 
effect  of  emotional  states  on  the  movements  of 
the  intestines.  Esselmont,  in  a  study  of  the 
dog's  intestine,  noted  constantly  after  signs  of 
emotion  a  marked  increase  of  activity  lasting  for 
only  a  few  moments.  Fubini  also  observed  that 
fear  occasioned  more  rapid  peristalsis.  There 
is  no  doubt  that  many  emotional  states  are  a 

[383] 


T^he  A,B,'  Z,  of  Our  Own  Nutrition 


strong  stimulus  to  peristalsis,  but  it  is  equally 
true  that  other  emotional  states  inhibit  peristalsis. 
In  the  cat  the  same  conditions  which  stop  the 
movements  of  the  stomach  stop  also  the  move- 
ments of  the  intestines. 

The  female  cats  used  in  these  observations 
ordinarily  lie  quietly  on  the  holder  and  make 
no  demonstration.  Sometimes,  however,  with 
only  a  little  premonitory 
restlessness,  the  cat  sud- 
denly flies  into  a  rage, 
(\   y         If  lashing  her  tail  from  side 

11  \     /  to  side,  pulling  and  jerk- 

ing with  every  limb,  and 
biting  at  everything  near 
her  head.  During  such 
excitement,  and  for  some 
moments  after  the  animal 
becomes  pacified  again, 
the  movements,  both  of  the  large  and  small  in- 
testine, entirely  cease.  Such  violence  of  excite- 
ment is  not  necessary  to  cause  the  movements 
to  stop;  a  cat  which  was  restless  and  contin- 
ually whining  while  confined  to  the  holder 
showed  no  signs  of  intestinal  movements  dur- 
ing any  period  of  observation  (one  period 
lasted  more  than  an  hour),  although  the  changes 
in  the  distribution  of  the  food  observable  from 
one  period  to  the  next  proved  that  movements 

[384] 


Figure  10. — Tracings  show- 
ing the  effect  of  excite- 
ment on  antiperistalsis  in 
the  colon. 


The  A.B,-Z.  of  Our  Own  Nutrition 

were  going  on  during  the  quiet  intermissions. 
In  another  cat,  uneasy  and  fretful  for  fifty  min- 
utes, no  activity  was  seen ;  then  she  became  quite 
for  several  minutes,  and  peristalsis  of  the  small 
intestine  appeared. 

When  the  segmentation  process  in  the  small 
intestine  is  stopped  by  excitement  the  segments 
unite  and  the  series  of  parts  returns  to  the  form 
of  a  solid  string.  The  change  occurring  in  the 
large  intestine  when  the  antiperistalsis  is  inhibited 
by  excitement  is  shown  in  Figure  lo.  The  tonic 
constrictions  in  the  descending  colon  are  appar- 
ently not  affected  by  emotional  states,  for  they 
do  not  seem  to  relax  in  the  excitement  which 
causes  the  movements  to  cease. 

By  holding  the  mouth  and  nostrils  closed,  or 
by  pressing  between  the  rami  of  the  jaw,  the 
breathing  may  be  stopped.  As  soon  as  the  cat 
shows  distress  from  lack  of  breath  every  form 
of  intestinal  movement  stops. 

The  statement  is  sometimes  made  in  text- 
books of  physiology  that  the  gastric  and  intestinal 
mechanisms  cease  to  act  during  sleep.  It  is 
worthy  of  note  that  nearly  all  the  animals  curled 
up  and  slept  during  the  time  between  obser- 
vations ;  nevertheless,  the  progress  of  the  food 
through  the  intestines  continued.  The  state- 
ment is  also  made  that  at  night,  even  without 
sleep,  the  intestines  are  almost  entirely  at  rest; 

»s  [  385  ] 


The  A.B,-  Z.  of  Our  Own  Nutrition 

that  this  is  their  normal  time  for  repose.  I  have 
seen  both  large  and  small  intestines  actively  at 
work,  however,  from  half  past  nine  until  half 
past  ten  o'clock  at  night. 

Summary 

1.  Bismuth  subnitrate,  lO  to  33  per  cent, 
mixed  with  the  food  renders  the  movement  of 
the  intestinal  contents,  and  thereby  the  move- 
ments of  the  intestinal  walls,  visible  on  the 
fluorescent  screen. 

2.  The  activity  most  commonly  seen  in  the 
small  intestine  is  the  simultaneous  division  of 
the  food  in  a  coil  into  small  segments,  and  a 
rhythmic  repetition  of  the  segmentation  each 
time  applied  to  the  new  segments  formed  from 
parts  of  those  just  divided.  In  the  cat  this 
rhythmic  segmentation  may  proceed  at  the  rate 
of  thirty  divisions  per  minute.  The  effects  of  the 
constrictions  causing  the  segmentation  are  the 
mixing  of  the  food  and  the  digestive  juices, 
the  bringing  of  the  digested  food  into  contact 
with  the  absorbing  mechanisms,  and  the  empty- 
ing of  the  venous  and  lymphatic  radicles  of  their 
contents  by  compression  of  the  intestinal  wall. 

3.  Peristalsis  is  usually  combined  with  seg- 
mentation. As  the  food  is  advancing,  interfering 
constrictions  often  separate  the  rear  end  of  the 
mass  from  the  main  body.     The  separation  is 

[386] 


The  A.B.-Z,  of  Our  Own  Nutrition 

momentary,  however ;  the  rear  end  is  swept  into 
union  with  the  main  body  again,  and  the  whole 
mass  is  pushed  onward  until  another  constriction 
repeats  the  changes. 

4.  The  ileocaecal  valve  is  thoroughly  com- 
petent for  food  entering  the  colon  from  the 
ileum. 

5.  The  usual  movement  of  the  transverse 
and  ascending  colon  and  the  caecum  is  an 
antiperistalsis.  This  recurs  in  periods  about 
every  fifteen  minutes,  and  each  period  lasts  com- 
monly about  five  minutes ;  the  waves  recur  dur- 
ing a  period  at  the  rate  usually  of  eleven  waves 
in  two  minutes.  This  antiperistalsis  gives  new 
significance  to  the  ileocaecal  valve  ;  for  the  food, 
now  in  a  closed  sac,  is  thoroughly  churned  and 
mixed  by  the  constrictions  running  towards  the 
caecum,  and  again  exposed  to  absorbing  walls 
without  any  interference  with  the  processes  in 
the  small  intestine. 

6.  As  soon  as  new  food  enters  the  large 
intestine  a  strong  general  contraction  takes  place 
along  the  caecum  and  ascending  colon,  forcing 
some  of  the  food  onward ;  a  moment  later 
antiperistaltic  waves  begin  to  pass. 

7.  With  the  accumulation  of  material  in  the 
transverse  colon,  deep  tonic  constrictions  ap- 
pear one  after  another  and  carry  the  material 
into  the   descending  colon,  leaving   the  trans- 

[387  J 


The  A.B.'Z,  of  Our  Own  Nutrition 

verse  and  ascending  portions  free  for  the  anti- 
peristaltic waves. 

8.  In  emptying  the  large  intestine  the 
material  in  the  lower  descending  colon  is  first 
carried  out  by  combined  peristalsis  and  pressure 
of  abdominal  muscles;  the  remainder  of  the 
material  is  then  spread  into  the  evacuated  region, 
and  this  region  is  again  cleared;  the  second  re- 
mainder may  be  similarly  affected.  In  normal 
life  the  new  food  arriving  in  the  colon  must 
force  forward  the  old  contents  of  the  ascending 
and  transverse  colon. 

9.  The  observations  have  revealed  no  evi- 
dence of  antiperistalsis  in  the  small  intestine, 
but  since  the  ileocaecal  valve  will  allow  nutrient 
material  under  pressure  to  pass  backward,  the 
antiperistalsis  of  the  large  intestine  may  force 
into  the  small  intestine  a  considerable  portion 
of  a  large  nutrient  enema.  Segmentation  in 
the  small  intestine  affects  such  an  enema  pre- 
cisely as  it  affects  food  which  has  passed  nor- 
mally through  the  stomach. 

10.  Signs  of  emotion,  such  as  fear,  distress, 
or  rage,  are  accompanied  by  a  total  cessation  of 
the  movements  of  both  large  and  small  intes- 
tines. The  movements  continue  in  the  cat  both 
during  sleep  and  at  night. 


[388] 


THE  BATTLE  CREEK  LABORATORIES 

THE  MAMMOTH  SANITARIUM  AND  THE 

LARGE  ADOPTED  FAMILY 

OF  DR.  AND  MRS.  J.  H.  KELLOGG 

[A  report  of  one  experiment  has  been  selected  from 
Modern  Medicine  relative  to  the  work  of  the  laboratories  con- 
nected with  the  Battle  Creek  Sanitarium  because  it  relates  to 
the  effect  of  cooking  and  mastication  upon  food  in  illustration 
of  the  statement  of  Dr.  Campbell  pertaining  to  these  aids  to 
digestion.  Much  more  evidence  could  be  had  from  the  Sani- 
tarium reports,  but  sufficient  has  already  been  given  herewith 
from  various  authoritative  sources  to  justify  our  claims  of  the 
great  importance  of  mouth-treatment  in  human  nutrition. 

It  may  be  said  here,  however,  that  the  trial  of  thorough 
mouth-work  as  an  aid  to  digestion,  which  has  been  in  progress 
at  the  Sanitarium  for  more  than  a  year,  and  which  has  finally 
been  accepted  and  prescribed  as  the  first  requirement  of  the 
treatment  of  patients,  is  of  the  utmost  significance.  This  is, 
by  far,  the  largest  sanitarium  in  the  world,  having  some  hun- 
dreds of  physicians,  nurses,  and  other  attaches,  and  treating 
many  thousands  of  patients  annually.  The  "  cure  "  is  based 
upon  natural  methods  of  recuperation,  and  while  all  of  the 
staff,  both  medical  and  surgical,  are  fully  equipped  diploma- 
tists, and  whereas  the  organisation  has  a  legally  and  profession- 
ally accepted  medical  school  of  its  own,  so-called  medicines 
are  rarely  used,  and  never  except  as  antidotes  to  specific 
poisons.  Nature  is  assisted  by  scientific  means  to  do  the 
curing,  and  now  that  an  economic  nutrition  to  relieve  the 
exhausted  system  of  the  patient  from  all  possible  strain 
through  ample  mouth-treatment  of  food,  as  intended  by  the 
anatomical,  dental,  and  chemical  plan  on  which  man  is  con- 
structed, has  been  tried  and  accepted  as  a  fundamental  prin- 
ciple of  the  institution,  it  gives  a  practical  indorsement  of  the 
claims  set  forth  in  "  Glutton  or  Epicure,"  and  in  this  present 

[389] 


The  A.B,-Z,  of  Our  Own  Nutrition 

book,  and  declares  that  they  are  of  greatest  importance  in 
securing  health  and  efficiency. 

The  Battle  Creek  Sanitarium  is  a  philanthropic  and 
humanitarian  institution  operating  under  a  perpetual  charter 
which  compels  the  use  of  all  the  profits  gained  to  foster  the 
spread  of  the  humanitarian  work.  More  than  sixty  branches 
of  the  parent  institution  have  been  established  in  or  near  large 
cities  in  different  parts  of  the  world,  under  the  title  of  The 
American  Medical  Missionary  Association,  and  each  of  these 
branches  conducts  a  life-saving  business  on  Good  Samaritan 
principles.  The  organisation  started  its  medical  missionary 
work  some  thirty-seven  years  ago,  with  almost  no  capital  and 
only  one  patient,  in  a  small  two-storey  frame  house,  in  the 
then  small  village  of  Battle  Creek,  Michigan.  The  incorpo- 
rators were  religious  enthusiasts  who  believed  that  Chris- 
tianity should  be  expressed  in  works  as  much  as  in  faith,  in 
curing  the  sick  and  healing  the  wounded,  and  thus  prepar- 
ing the  unfortunate  for  the  reception  of  moral  and  spiritual 
inspiration. 

The  best  evidence  that  this  scheme  of  procedure  to  attain 
the  ultimate  end  was  a  good  one  is  shown  by  the  success 
of  the  institution  in  its  growth  from  such  small  beginning  to 
the  immense  proportions  of  the  present  time,  with  one  of  its 
buildings  nearly  a  thousand  feet  in  length  and  five  storeys 
in  height  and  numerous  other  buildings  radiating  from  the 
main  one  and  scattered  about  it  in  a  finely  wooded  park. 
Fire  came  and  destroyed  the  old  building  and  all  its  contents, 
but  yet  it  was  soon  rebuilt,  and  the  concern  goes  on  growing 
and  growing,  because  the  foundation  principle  of  the  institu- 
tion is  the  beautiful  Golden  Rule,  and  the  method  of  treat- 
ment employed  is  taken  from  the  open  book  of  Nature. 

While  the  organisation  was  primarily  based  upon  a  special 
religious  creedal  enthusiasm,  it  has  become  so  broadly  altru- 
istic as  to  suggest  a  return  to  original  Christianity  as  defined 
in  the  Sermon  on  the  Mount.  In  such  Christian  expression 
honest  agnostics,  born  Buddhists,  and  the  tolerant  of  all  the 
different  Christian  creeds  may  join  and  say  amen ! 

One  of  the  splendid  results  of  an  economic  nutrition, 
attained  by  following  the  natural  requirements  and  impulses, 
is  the  curing  of  many  diseases,  among  them  several  forms  of 
constipation.     The  writer  has  a  genuine  admiration  for  the 

[390] 


The  A,  B.-  Z,  of  Our  Own  Nutrition 

spirit  that  is  the  motive  power  of  the  Battle  Creek  Sanitarium 
and  firm  belief  in  the  Christianity  demonstrated  in  the  work, 
especially  in  the  private  experiment  of  Dr.  and  Mrs.  Kellogg, 
with  their  family  of  adopted  waifs.  Twenty-four  children  of 
unfortunate  parents,  waifs  so  unfortunate  in  their  attractability 
as  to  be  hopelessly  neglected,  have  been  gathered  under  this 
sheltering  roof  and  are  showing  their  mettle  and  gratitude  by 
splendid  behaviour  and  brilliant  accomplishment  in  a  manner 
that  any  proud  parent  might  approve.  To  miss  any  oppor- 
tunity to  express  gratitude  to  Dr.  and  Mrs.  Kellogg  for  giving 
us  such  a  splendid  example  of  the  true  meaning  of  practical 
Christianity  would  be  showing  symptoms  of  the  worst  form  of 
constipation;  viz.,  constipation  of  appreciation  and  affection. 
—  Horace  Fletcher.] 


EXPERIMENTAL  INVESTIGATION  OF 
THE  INFLUENCE  OF  MASTICATION 
AND  COOKING  OF  FOOD,  ETC.,  IN 
THE  LABORATORIES  OF  THE  BAT- 
TLE CREEK,  MICHIGAN,  SANITA- 
RIUM, UNDER  THE  DIRECTION  OF 
DR.  J.    H.   KELLOGG 

From  Modern  Medicine 

The  table  clearly  shows  the  effect  of  cooking 
and  the  effect  of  mastication  upon  the  salivary 
digestion  of  food.  Column  i  shows  the  results 
obtained  after  an  ordinary  test  meal  consisting 
of  i^  ounces  of  water  biscuit  to  8  ounces  of 
water;  column  2,  \\  ounces  of  water  biscuit 
ground  fine,  mixed  with  water  and  swallowed 
without  chewing;  column  3,  test  meal  consist- 
[391] 


The  A,B,-Z.  of  Our  Own  Nutrition 

ing  of  \\  ounces  of  raw  wheat  flour  and  8 
ounces  of  water ;  column  4,  test  meal  consist- 
ing of  \\  ounces  of  unground  pearled  wheat 
with  8  ounces  of  water. 


Total  acidity  (A)  .  . 
Calculated  acidity  (A') 
Total  chlorine  (T)  . 
Free  HCl  (H)  .  .  . 
Combined  chlorine  (C) 
Fixed  chlorides  (F)  . 
Maltose  (M)  .  .  . 
Dextrine  and  soluble  starch 
(I>) 


COEFFICIENTS 


Digestion  of  albumin  {a) 
Digestion  of  starch  (b)  . 
Salivary  activity  {c)  .  . 
Fermentation  {x)  .  .  . 
Chlorine  liberation  (m)  . 


Water 
biscuit, 

well 
chewed. 


0.142 
0.156 
0.296 
0.050 
0.106 
0.II4 
1.088 


0.812 


0.82 
0.71 
1. 17 
5.00 
0.80 


Water 
biscuit, 

not 
chewed. 


0.140 
0.132 
0.284 
0.028 
0.104 
0.152 
0.272 

0.548 


0.97 
0.42 
I. II 
11.00 
0.70 


Raw 
flour. 


0.204 
0.186 

0-332 
0.056 
0.130 
0.146 
0.000 

0.300 


1. 00 
0.00 
1. 14 
6.00 
0.85 


Raw 

wheat. 


0.136 
0.128 
0.272 
0.052 
0.076 
0.144 
0.000 

0.448 


1. 00 
0.00 

6.00 
0.71 


Several  points  of  interest  are  to  be  noted 
in  the  above  table,  the  first  and  most  conspicu- 
ous of  which  is  the  fact  that  the  saliva  did  not 
act  at  all  upon  the  raw  flour  and  raw  wheat,  as 
shown  by  the  total  absence  of  maltose  in  the 
cases  represented  in  columns  3  and  4.  The 
small  amount  of  dextrine  and  soluble  starch 
shown  was,  perhaps,  already  present  in  the  raw 
[392  ] 


The  A.B,-Z,  of  Our  Own  Nutrition 

grain,  but  this  point  I  have  not  investigated.  It 
is  clear,  however,  that  no  sugar  was  produced 
when  raw  starch  was  taken,  whereas  the  amount 
of  sugar  produced  after  the  ordinary  test  meal 
was  more  than  i  gram  in  each  lOO  c.c.  of  stom- 
ach fluid ;  in  other  words,  the  stomach  fluid 
contained  more  than  one  per  cent  of  sugar  with- 
out taking  into  account  the  amount  which  had 
been  absorbed. 

The  figures  for  maltose  in  column  2  repre- 
sent a  test  meal  in  which  little  or  no  saliva  was 
mixed  with  the  test  meal,  the  food  being  swal- 
lowed without  chewing,  indicating  very  slight 
action  of  the  saliva,  the  amount  of  maltose 
found  in  the  stomach  fluid  being  but  a  trifle 
more  than  one-fourth  the  amount  obtained  after 
an  ordinary  test  meal.  The  amount  of  soluble 
starch  and  dextrine  was  less  than  half  the  nor- 
mal amount  in  the  case  of  the  raw  flour,  and 
but  little  more  in  the  case  of  the  raw  wheat. 

Another  point  of  interest  is  the  increased 
amount  of  lactic  acid  found  in  the  test  meal 
taken  without  chewing,  represented  in  column  2. 
The  coefficient  of  fermentation  which  represents 
the  number  of  milligrams  of  lactic  acid  (as  ex- 
pressed in  terms  of  HCl)  found  in  ICX)  c.c.  of 
stomach  fluid  was  more  than  double  that  found 
after  the  same  kind  of  test  breakfast  properly  mas- 
ticated, represented  in  column  i.  The  results 
[393] 


The  A,B.'  Z.  of  Our  Own  Nutrition 

of  this  experiment  distinctly  associate  acid  fer- 
mentation with  imperfect  mastication  and  im- 
perfect salivary  digestion. 

Another  fact  noted  in  a  comparative  study 
of  the  results  of  the  analysis  of  over  5000  stom- 
ach fluids,  which  very  strongly  confirms  this 
idea,  is  that  starch  conversion  is  usually  com- 
plete in  cases  of  apepsia,  while  lactic  acid  is 
conspicuous  by  its  absence.  In  nearly  all  cases 
of  apepsia  which  I  have  encountered,  number- 
ing about  forty  cases  in  all,  the  most  delicate 
tests  for  lactic  acid  have  failed  to  show  its  pres- 
ence except  in  the  most  minute  quantities;  in 
most  cases  it  was  entirely  absent. 

There  are  a  number  of  other  points  of  in- 
terest in  the  above  table  in  addition  to  those 
which  relate  particularly  to  starch  digestion. 
One  of  the  most  noteworthy  of  these  is  the  fact 
that  the  digestion  of  albumen  was  not  unfavoura- 
bly influenced  by  the  neglect  to  masticate  the 
food,  the  coefficient  of  digestion,  in  fact,  being 
raised  from  .82  to  .97.  This  coefficient  is  a 
qualitative  and  not  a  quantitative  index.  The 
higher  coefficient  indicates  a  more  perfect  elabo- 
ration of  proteids  and  a  close  approach  to  an 
absolutely  perfect  proteid  digestion. 

Another  fact  of  perhaps  even    greater   in- 
terest has  relation  to  the  digestion  of  albumen 
when  the  wheat  was  eaten  raw,  in  the  form  of 
[394] 


The  A,B.-  Z.  of  Our  Own  Nutrition 

either  flour  or  wheat.  The  coefficient  of  proteid 
digestion  in  both  cases,  as  shown  in  columns 
3  and  4,  was  i.oo,  indicating  perfect  elaboration 
of  the  albuminoids.  From  this  it  appears  that 
raw  gluten,  or  the  proteids  of  wheat,  is  digested 
more  perfectly  when  taken  in  a  raw  state  than 
when  cooked,  the  very  opposite  of  which  we 
have  seen  to  be  true  of  starch.  The  digestion 
of  raw  starch  may  take  place  in  the  intestines, 
by  the  action  of  the  pancreatic  juice,  but  can- 
not take  place  in  the  stomach,  for  the  reason 
that  the  saliva  has  not  the  power  to  penetrate 
the  cellulose  envelope  of  the  starch  granule, 
and  hence  cannot  digest  raw  starch. 

This  fact  coincides  in  a  most  interesting 
manner  with  the  biological  fact  that  man  is 
by  nature  a  frugivorous  animal.  In  the  proc- 
ess of  ripening,  the  starch  of  fruits  undergoes 
a  hydration  similar  to  that  which  takes  place  in 
cooking  and  in  pancreatic  digestion,  whereby 
the  insoluble  starch  is  converted  into  soluble 
starch,  dextrine,  and  sugar.  This  explains,  also, 
why  well-ripened  fruit  may  be  eaten  raw  with 
impunit)^  while  unripe  fruit  and  farinaceous 
food  of  all  sorts  require  cooking.  In  his  diet, 
man,  like  his  nearest  relative,  the  monkey,  be- 
ing naturally  a  frugivorous  animal,  may  eat  fruits 
in  the  state  in  which  Nature  has  provided  them; 
but  when  he  introduces  other  natural  products 
[395] 


'The  A,B.-  Z.  of  Our  Own  Nutrition 

into  his  bill  of  fare,  he  must  adopt  artificial 
means  for  securing  the  preparation  for  diges- 
tion which  Nature  makes  in  the  ripening  process 
of  fruits. 

The  coefficient  of  chlorine  liberation  {in)  is 
very  nearly  uniform,  indicating  that  the  masti- 
cation of  food  and  the  cooking  of  food  have  little 
influence  upon  this  digestive  function. 

The  coefficient  of  salivary  activity  (^)  was 
determined  independently  for  each  test  break- 
fast. Its  practical  uniformity  indicates  that  there 
was  no  essential  change  in  the  character  or  qual- 
ity of  the  saliva  to  account  for  the  differences 
shown  by  the  totals  in  relation  to  the  stomach 
digestion  of  starch. 


DR.   EDWARD   HOOKER    DEWEY   AND   THE 
"NO   BREAKFAST   PLAN" 

The  "  No  Breakfast  Plan,"  evolved  from  the  long  experi- 
mental experience  of  Dr.  Dewey,  to  secure  much  needed  rest 
for  the  stomach  and  intestines,  is  described  in  a  book  bearing 
that  title  which  can  be  had  direct  from  the  author  by  address- 
ing him  at  his  home,  Meadville,  Penn.,  U.  S.  A. 

**  No  Breakfast  "  is,  evidently,  a  misnomer,  but  means,  in 
the  present  application,  an  appetite  eartted  after  arising  from 
sleep.  The  writer,  for  instance,  often  begins  work  so  early  in 
the  morning  that  by  the  time  the  ordinary  breakfast  is  ready 
he  has  already  done  a  fair  day's  work. 

The  writer  has  no  reported  details  of  the  work  of  Dr. 
Dewey  to  add  to  this  volume.  In  "Glutton  or  Epicure" 
full  appreciation  of  this  Esculapian  Luther  is  expressed  and 
extracts  of  his  writings  are  reprinted.  In  fighting  for  more 
than  forty  years  for  the  principle  of  less  abuse  of  the  tired 

[396] 


The  A.B.-Z.  of  Our  Own  Nutrition 

body  of  man,  Dr.  Dewey  has  rendered  a  service  that  some 
time  will  be  reckoned  very  great ;  and  while  there  is  no 
scientific  report  of  the  good  doctor's  work  to  call  for  intro- 
ductory comment,  it  would  be  equally  unhealthy  to  miss  an 
opportunity  to  express  gratitude  for  what  he  has  done  for  us 
all. 

PROFESSOR   JAFFA   AND  THE  FRUITARIANS 

Professor  Jaffa,  too,  of  the  University  of  California,  has 
been  doing  most  valuable  service  in  testing  the  usefulness  of 
fruits  and  nuts  as  human  foods.  He  generously  furnished  the 
author  with  elaborate  tables  of  his  results,  covering  several 
years  of  observation,  showing  low  nitrogen  possibilities  similar 
to  those  demonstrated  by  the  writer  and  his  colleagues  at 
Cambridge  and  Yale.  These  have  since  been  published,  and 
relating  to  special  kinds  of  foods,  as  they  do,  suggest  a  wide 
range  of  choice  among  the  fruits  of  earth  ;  but  the  collected 
evidence  of  this  book  shows  that  human  nutrition  is  best 
served  when  the  appetite,  being  kept  at  normal,  is  allowed  to 
make  selection  from  the  whole  range  of  nutritious  products 
furnished  by  good  Mother  Nature. 


DR.    H.   P.   ARMSBY 

In  the  Oct.  i6th,  1903,  number  of  Science,  also,  is  an  inter- 
esting article  by  Dr.  H.  P.  Armsby  on  the  heat  values  and 
muscular  energy  values  of  different  food  elements  and  their  iso- 
dynamic  replacement  of  each  other  under  various  conditions. 
—  Horace  Fletcher.] 


[397] 


Explanation   of  The   A.  B.  C, 

Life   Series 

THE  ESSENTIALS  AND  SEQUENCE  IN  LIFE 

It  would  seem  a  considerable  departure 
from  the  study  of  m.enticulture  as  advised 
in  the  author's  book,  "  Menticulture,"  to 
jump  at  once  to  an  investigation  of  the 
physiology  and  psychology  of  nutrition  of 
the  body  and  then  over  to  the  department 
of  infant  and  child  care  and  education  as 
pursued  in  the  creche  and  in  the  kinder- 
garden  ;  but  as  a  matter  of  fact,  if  study 
of  the  causation  of  human  disabilities  and 
misfortunes  is  attempted  at  all,  the  quest 
leads  naturally  into  all  the  departments  of 
human  interest,  and  first  into  these  primary 
departments. 

The  object  of  this  statement  is  to 
link  up  the  different  publications  of  the 
writer  into  a  chain  of  consistent  sugges- 
tions intended  to  make  life  a  more  simple 
[399] 


Explanation  of  The  A.  B.  C.  Life  Series 

and  agreeable  problem  than  many  of  us 
too  indifferent  or  otherwise  inefficient  and 
bad  fellow-citizens  make  of  it. 

It  is  not  an  altogether  unselfish  effort 
on  the  part  of  the  author  of  the  A.  B.  C. 
Life  Series  to  publish  his  findings.  In  the 
consideration  of  his  own  mental  and  physi- 
cal happiness  it  is  impossible  to  leave  out 
environment,  and  all  the  units  of  humanity 
who  inhabit  the  world  are  part  of  his  and 
of  each  other's  environment. 

It  would  be  rank  presumption  for  any 
person,  even  though  gifted  with  the  means 
to  circulate  his  suggestions  as  widely  as 
possible,  and  armed  with  the  power  to 
compel  the  reading  of  his  publications, 
to  think  that  any  suggestions  of  his  could 
influence  any  considerable  number  of  his 
fellow-citizens  of  the  world,  or  even  of  his 
own  immediate  neighbourhood,  to  accept 
or  follow  his  advice  relative  to  the  man- 
agement of  their  lives  and  of  their  com- 
munal and  national  affairs ;  but  while  the 
general  and  complete  good  of  humanity 
should  be  aimed  at  in  all  publications, 
one's  immediate  neighbours  and  friends 
[  400] 


Explanation  of  The  A,  B.  C.  Life  Series 

come  first,  and  the  wave  of  influence 
spreads  according  to  the  effectiveness  of 
the  ideas  suggested  in  doing  good;  that 
is,  in  altering  the  point  of  view  and  con- 
duct of  people  so  as  to  make  them  a  better 
sympathetic  environment. 

For  instance,  the  children  of  your 
neighbours  are  likely  to  be  the  playmates 
of  your  own  children,  and  the  children  of 
degenerate  parents  in  the  slum  district 
of  your  city  will  possibly  be  the  fellow- 
citizen  partners  of  your  own  family.  Again, 
when  it  is  known  that  right  or  wrong  nu- 
trition of  the  body  is  the  most  important 
agent  in  forming  character,  in  establish- 
ing predisposition  to  temperance  or  intem- 
perance of  living,  including  the  desire  for 
intoxicating  stimulants,  it  is  revealed  to 
one  that  right  nutrition  of  the  community 
as  a  whole  is  an  important  factor  in  his 
own  environment,  as  is  self-care  in  the 
case  of  his  own  nourishment. 

The   moment   a  student  of   every-day 

philosophy  starts   the  study  of   problems 

from    the  A.  B.   C.  beginning  of  things, 

and  to  shape  his  study  according  to  an 

26  [  401  ] 


Explanation  of  The  A.  B,  C,  Life  Series 

A.  B.  C.  sequence,  each  cause  of  inhar- 
mony  is  at  once  traced  back  to  its  first  ex- 
pression in  himself  and  then  to  causes 
influenced  by  his  environments. 

If  we  find  that  the  largest  influences 
for  good  or  bad  originate  with  the  right 
or  wrong  instruction  of  children  during 
the  home  training  or  kindergarden  period 
of  their  development,  and  that  a  dollar 
expended  for  education  at  that  time  is 
worth  more  for  good  than  whole  bancs 
of  courts  and  whole  armies  of  police  to 
correct  the  effect  of  bad  training  and  bad 
character  later  in  life,  it  is  quite  logical 
to  help  promote  the  spread  of  the  kinder- 
garden  or  the  kindergarden  idea  to  include 
all  of  the  children  born  into  the  world, 
and  to  furnish  mothers  and  kindergarden 
teachers  with  knowledge  relative  to  the 
right  nutrition  of  their  wards  which  they 
can  themselves  understand  and  can  teach 
effectively  to  children. 

If  we  also  find  that  the  influence  of  the 
kindergarden  upon  the  parents  of  the  in- 
fants is  more  potent  than  any  other  which 
can  be  brought  to  bear  upon  them,  we  see 
[  402  ] 


Explanation  of  The  A.  B.  C,  Life  Series 

clearly  that  the  way  to  secure  the  widest 
reform  in  the  most  thorough  manner  is 
to  concentrate  attention  upon  the  kinder- 
garden  phase  of  education,  advocate  its 
extension  to  include  even  the  last  one  of 
the  children,  beginning  with  the  most 
needy  first,  and  extending  the  care  out- 
ward from  the  centre  of  worst  neglect  to 
finally  reach  the  whole. 

Experience  in  child  saving  so-called, 
and  in  child  education  on  the  kinder- 
garden  principle,  has  taught  the  cheapest 
and  the  most  profitable  way  to  insure 
an  environment  of  good  neighbours  and 
profit-earning  citizens  ;  and  investigation 
into  the  problem  of  human  alimentation 
shows  that  a  knowledge  of  the  elements  of 
an  economic  nutrition  is  the  first  essential 
of  a  family  or  school  training;  and  also 
that  this  is  most  impressive  when  taught 
during  the  first  ten  years  of  life. 

One  cannot  completely  succeed  in  the 
study  of  menticulture  from  its  A.  B.  C. 
beginning  and  in  A.  B.  C.  sequence  with- 
out appreciation  of  the  interrelation  of 
the  physical  and  the  mental,  the  personal 
[403] 


Explanation  of  The  A,  B,  C.  Life  Series 

and   the   social,  in    attaining  a  complete 
mastery  of  the  subject. 

The  author  of  the  A.  B.  C.  Life 
Series  has  pursued  his  study  of  the 
philosophy  of  life  in  experiences  which 
have  covered  a  great  variety  of  occupa- 
tions in  many  different  parts  of  the  world 
and  among  peoples  of  many  different 
nations  and  races.  His  first  book,  "  Men- 
ticulture,"  dealt  with  purging  the  mind 
and  habits  of  sundry  weaknesses  and  de- 
terrents which  have  possession  of  people 
in  general  in  some  degree.  He  recog- 
nised the  depressing  effect  of  anger  and 
worry  and  other  phases  of  fearthoughL 
In  the  book  "  Happiness,"  which  followed 
next  in  ox^^x  fear  thought  was  shown  to  be 
the  unprofitable  element  of  forethought. 
The  influence  of  environment  on  each 
individual  was  revealed  as  an  important 
factor  of  happiness,  or  the  reverse,  by 
means  of  an  accidental  encounter  with  a 
neglected  waif  in  the  busy  streets  of 
Chicago  during  a  period  of  intense 
national  excitement  incident  to  the  w^ar 
with  Spain,  and  this  led  to  the  publication 
[404] 


Explanation  of  The  A.  B.  C.  Life  Series 

of  "  That  Last  Waif ;  or,  Social  Quaran- 
tine." During  the  time  that  this  last 
book  was  being  written,  attention  to  the 
importance  of  right  nutrition  was  invited 
by  personal  disabilities,  and  the  experi- 
ments described  in  "  Glutton  or  Epicure  ; 
or,  Economic  Nutrition  "  were  begun  and 
have  continued  until  now. 

In  the  study  of  the  latter,  but  most 
important  factor  in  profitable  living,  cir- 
cumstances have  greatly  favoured  the 
author,  as  related  in  his  latest  book, 
"  The  A.  B.-Z.  of  Our  Own  Nutrition." 

The  almost  phenomenal  circulation  of 
"  Menticulture "  for  a  book  of  its  kind, 
and  a  somewhat  smaller  interest  in  the 
books  on  nutrition  and  the  appeal  for 
better  care  of  the  waifs  of  society,  showed 
that  most  persons  wished,  like  the  au- 
thor, to  find  a  short  cut  to  happiness  by 
means  of  indifference  to  environment, 
both  internal  and  external,  while  habitu- 
ally sinning  against  the  physiological 
dietetic  requirements  of  Nature.  In  smoth- 
ering worry  and  guarding  against  anger  the 
psychic  assistance  of  digestion  was  stimu- 
[405  j 


Explanation  of  The  A.  B,  C,  Life  Series 

lated  and  some  better  results  were  thereby 
obtained,  but  not  the  best  attainable 
results. 

Living  is  easy  and  life  may  be  made 
constantly  happy  by  beginning  right;  and 
the  right  beginning  is  none  other  than 
the  careful  feeding  of  the  body.  This 
done  there  is  an  enormous  reserve  of 
energy,  a  naturally  optimistic  train  of 
thought,  a  charitable  attitude  towards 
everybody,  and  a  loving  appreciation  of 
everything  that  God  has  made.  Morbid- 
ity of  temperament  will  disappear  from  an 
organism  that  is  economically  and  rightly 
nourished,  and  death  will  cease  to  have 
any  terrors  for  such  ;  and  as  fear  of  death 
is  the  worst  depressant  known,  many  of 
the  worries  of  existence  take  their  ever- 
lasting flight  from  the  atmosphere  of  the 
rightly  nourished. 

The  wide  interest  now  prevalent  in 
the  subjects  treated  in  The  A.  B.  C.  Life 
Series  is  evidenced  by  the  scientific,  mili- 
tary, and  lay  activity  in  connection  with 
the  experiments  at  the  Sheffield  Scientific 
School  of  Yale  University  and  elsewhere, 
[406] 


'Explanation  of  The  A.  B,  C.  Life  Series 

as  related  in  the  "  A.  B.-Z.  of  Our  Own 
Nutrition  "  and  in  "  The  New  Glutton  or 
Epicure"  of  the  series. 

The  general  application  is  more  fully 
shown,  however,  by  the  indorsement  of 
the  great  Battle  Creek  Sanitarium,  which 
practically  studies  all  phases  of  the  sub- 
ject, from  health  conservation  and  child 
saving  to  general  missionary  work  in 
social  reform. 

HORACE   FLETCHER. 


Index 


A.  B.  C.  Life  Sbribs,  the,  xxiv,  15, 
47  ;  explanation  of,  399-407 

Abdominal  glands,  the,  189,  190 

muscles,  the,  326,  388 

wall,  the,  364 

Abernethy  biscuit,  131 

Acid  reaction,  of  food,  269 

Acids,  stimulating  properties  of,  270 ; 
supplement  weak  action  in  the 
stomach,  270;  special  relation  to 
the  pancreas  of,  270 

Addison,  Joseph,  upon  the  work  of 
Luigi  Comaro,  28 

Adenoids,  largely  dietetic  in  origin, 
148-152,  156 

Afferent  nerves,  special  duty  of  the 
peripheral  terminations  of,  184-185 

Agriculture,  U.  S.  Department  of,  37 

Albumen,  digestion  of,  394 

Albuminoids,  the,  395 

Albuminous  foods,  minimum  amount 
of,  74,  78 

Alcoholic  beverages,  explanation  of 
the  use  of,  252 

Algarroba  bean,  the,  124 

Alimentary  canal,  the,  13,  14,  15,  40; 
pabulum  derived  from,  40,  92,  117; 
Professor  Pawlow's  conclusions 
concerning,  186 ;  experimental  in- 
vestigation of  the  pathology  and 
therapeutics  of,  248,  260,  273,  275, 
276,  277 


Alimentation,  human,  study  of,   13 ; 

theory  of,  180 
Alkalies,  the,  278,  279,  280,  281,  aSa 
Alkaline    reduction,  33,   34,  35,   36, 


saliva,  33  ;  its  quantity  mc 

by  mastication,  96,  102,  146 

Alkalinisation,  92 

Altruism,    placed  upon    a    business 
basis,  xxiv 

American  Medical  Missionary  Asso- 
ciation, the,  390 

Medical  Missionary  Cause,  the, 

xxiii 

Physiological  Society,  the,  68 

Anderson,  Dr.  William  G.,  54,  87,  88 
Anger,  causes  indigestion,  7 
Animal  economy,  40 

food,  necessitates  less  thorough 

mastication  than  vegetable,  67,  99- 
100,  173  ;  influenced  less  than  vege- 
table by  cooking,  118 

organism,  the  efficiency  of,  58 

Anthropoid  apes,  115,  116 
Antiperistalsis,    326,    333,    342,    345, 

364 ;    in   the    colon,   365-370 ;   the 

question  of,  377-383.  384,  385.  3871 

388 
Antiperistaltic  waves,  365,  367,  373, 

374,  376,  381,  383,  387,  388 
Antrum,  the,  307,  308,  311,  315,  33a, 

323,   326,   327,   333,  334,  336,  340* 

341.  360 
Apepsia,  394 


[409] 


Index 


Appendicitis,  relationship  between 
diet  and,    141 

Appendix,  the,  cause  of  catarrh  of, 
141 

Appetite,  demands  proteid  when 
wanted,  xxxii;  knows  what  to  do 
and  when  to  do  it,  xxxiii  ;  most 
important  factor  in  digestion,  6 ;  a 
perfect  indicator,  6;  a  creature  of 
the  mind,  7;  the  caprices  of,  7; 
easily  comprehended,  how  to  read, 
8,  9,  12 ;  an  indicator  of  what  the 
body  requires,  20;  will  close  the 
valve  when  enough  is  eaten,  20; 
striking  effect  of  insalivation  upon, 
50;  fully  understood,  prevents  in- 
temperance in  eating  or  drinking, 
95  ;  sooner  satisfied  with  thorough 
mastication,  137 ;  the  first  and 
mightiest  exciter  of  the  secretory 
nerves  of  the  stomach,  210;  is 
juice,  213  ;  Dr.  Pawlow's  experiment 
showing  value  of,  226;  its  initial 
impulse  may  originate  in  the  stom- 
ach, 244;  in  the  rich  and  in  the 
poor,  252-253 ;  care  should  be  taken 
of,  254 ;  physicians  most  often  called 
on  to  restore,  254 ;  remarkable  how 
little  attention  is  paid  to,  255 ;  bitters 
increase,  263,  265 ;  the  strongest  of 
all  stimuli  to  the  digestive  glands, 
263;  connection  between  gastric 
juice  and,  265. 

earned,  a  preliminary  necessity 

of  easy  digestion,  180 

,  false,  6,  9,  29,  75 

,  normal,  6 

"Appetite  juice,"  the,  213,  228,  258, 
259,  260 

Apples,  169 

Appreciation,  attention  necessary  to 
create,  7;  necessary  to  stimulate 
flow  of  digestive  juices,  7,  12 

[4 


Armsby,  Dr.  H.  P.,  on  the  heat 
values  and  muscular  energy  values 
of  different  food  elements,  397 

Asiatics,  the,  consume  smaller  pro- 
portion of  proteids,  82 

Asparagus,  93 

Astrup,  £. ,  126 

Athletes,  reason  for  training,  22 

Attention,  necessary  to  create  appre- 
ciation, 7;  how  to  command,  8,  9, 
12 

Atwater,  Prof.  W.  O.,  54;  on  the 
daily  proteid  requirement,  76 

Respiration  Apparatus,  the,  57 

Australians,  the,  118, 129,  163 


B 

Bachh  Fund,  the,  69 

Bacteria,  the  action  in  the  intestines 
of,  39.  "7 

Bacterial  digestion,  40 

flora,  the,  examination  of,  26 

Bacteriology,  advances  of,  248,  249 

Bailey,  128 

Balthazard,  experiments  of,  314,  315, 
327.  328 

Baltimore,  Md.,  68 

Barling,  Gilbert,  141 

Barrett,  Robert,  47 

Bayliss,  experiments  of,  343,  344,  345. 
359 

Batter  pudding,  98 

Battle  Creek,  Michigan,  390 

Laboratories,  the,  389-391 ;  ex- 
perimental investigation  of  the  in- 
fluence of  mastication  and  cooking 
of  food,  etc.,  in,  391-396 

Sanitarium,  the,  xvii,  xxiii,  xxvii ; 

described,  389-391 

Bayert,  123 

Beans,  95,  133 


Index 


Beaumont,  experiments  of,  305,  309, 
310,  313,  326,  327,  329,  330,  334, 
336 

Beef,  100 

Benedict,  Prof.  Francis  G.,  54 

Berlin,  56,  65 

Berne,  Switzerland,  284 

Betel,  chewing,  103,  128 

Beverages,  mastication  in  the  prepara- 
tion of,  123 

Bidder  and  Schmidt,  experiments  of, 
202,  204,  231 ;  conditions  for  suc- 
cess, 204-206 

Bile,  the,  360 

Bitters,  therapeutic  influence  of,  262, 
265  ;  increase  the  appetite,  263,  264, 
265 

Blondlot,  experiments  of,  181,  182, 
277 

Blood,  the,  toxins  absorbed  into,  40; 
influence  of  the  contraction  of  the 
masticatory  muscles  on  local  circu- 
lation of,  107,  148,  149,  278,  355 

elements,  the,  41 

Blumfield,  Dr.  Joseph,  26 

Body,  the,  considered  as  an  engine, 
4,  23;  derives  its  necessary  energy 
from  food,  72  ;  burdened  by  excess 
of  food,  73 

Boer  War,  the,  11 

Bolting  food,  35,  36,  134,  135,  138, 
140 

Bolus,  the,  329,  343,  344 

Boston  Society  of  Medical  Sciences, 
the,  342 

Bouillon,  266 

Bowditch,  Dr.  Prof.  Henry  Picker- 
ing, xxiv,  XXV,  67,  68,  70,  284,  285, 
287,  306 

Bowel,  the,  liable  to  suffer,  140,  345 

'*  Bracer,"  a,  why  required,  20 

Braun  and  Griitzner,  experiments  of, 

[4 


Bread,  78,  98,  99,  132,  137,  143,  171, 

270,  271,  274,  275 
Brinton,  experiments  of,  329, 330,  334, 

336 
British  Guiana,  124 
Medical  Association,  the,  27,  48, 

91,92 
"  British  Medical  Journal,"  the,  141 
Bronchitis,  144,  146' 
Broth,  strong,  268 
Brown  bread,  43 
Brussels,  68 
Buccal  digestion,  8 

nerves,  the,  194 

Bushmen,  the,  118,  123 
Butter,  43,  100 


Cabbage,  why  indigestible,  99 

Caecum,  the,  140,  141,  363,  364,  365, 
366,  368,  370,  371,  372,  375,  376, 
377,  381,  387 

Cake,  132 

California,  University  of,  90,  397 

Calm,  easy  to  cultivate,  7 

Cambridge,  England,  xxxi,  26,  47, 
49 

tests,  the,  47,  69 

University,  England,  xxv,  26,  53, 

68,91 

Campbell,  Dr.  Harry,  8^  12 ;  on  the 
importance  of  mastication,  92-179, 
389 

Cancer,  produced  by  inefficient  mas- 
tication, 138 

Cane-sugar,  changed  to  grape-sugar, 
21,169 

Cannon,  Dr.  W.  B.,  7,  12;  on 
"  Swallowing  and  Movements  o 
the  Stomach  and  Intestines,"  284- 
300 ;  on  the  "  Movements  of  the 
Stomach     Studied    by    means    of 

II] 


Index 


the  RSntgen  Rays,"  301-341  \  on 
the  "  Movements  of  the  Intestines 
Studied  by  Means  of  the  Rbntgen 
Rays,"  342-388 

Carbohydrate  foods,  78,  79,  80,  85,  86, 
89 

Cardia,  the,  ideas  of  early  writers  con- 
cerning, 303,  304,  325,  326,  328,  329 

Cardiac  sphincter,  the,  307 

Carelessness,  the  sin  of,  xvii 

Carnegie,  Andrew,  xxxv 

Institution,  the,  53 

Carnivora,  the,  do  not  masticate,  97, 
161 

Cassava  root,  124 

Cat,  the,  experiments  upon,  289-293, 
299>  303,  307,  3"i  312,  3x5,  320,  322, 
325.  333i 335.  337-339.  34'.  344.  353, 
359.  361,  365.  366,  372,  382,  383-386, 
388 

Catarrh  of  the  appendix,  caused  by 
inefficient  mastication,  141 

Cauliflower,  99 

"  Cause  and  Prevention  of  Decay  in 
Teeth,  the,"  Wallace's,  161 

Cavendish  lecture.  Sir  Frederick 
Treves's,  140 

Cell,  a,  determination  of  the  metabo- 
lism of,  40 

Cellulose,  117,  170 

Cereals,  78,  84,  146 

Ceylon,  128 

Cheese,  43,  95 ;  when  indigestible, 
100,  137 

Chemical  excitants,  the,  268 

secretion,  259 

Chemistry,  organic,  62 

,  physical,  62 

Chewing,  length  of  time  necessary 
for,  xxxii 

Chicken  bone,  166 

Chigin,  Dr.,  experiments  by,  214, 
216,  282 


[4 


Children,  early  feeding  of,  130-132, 
143  ;  defective  mastication  in,  148  ; 
feeding  of,  262 

Children's  Aid  Society,  the,  xxv, 
68 

Chimpanzee,  the,  115 

China,  82 

Chittenden,  Prof.  R.  H.,  conducting 
the  experiments  at  Yale,  xvii,  5  ; 
emphasises  the  want  of  exact  knowl- 
edge of  nutrition,  53 ;  67,  68 ;  the 
Yale  test,  69-91. 

Chop  bone,  166 

Chyme,  the,  346,  360,  362 

Circulation,  the,  stimulated  by  mas- 
tication, 96,  103,  157 

Cocoa-nut,  137 

Coffee,  132 

Cole,  Sidney  W. ,  47  ;  his  paper  upon 
the  isolation  of  the  tryptophane 
element  of  the  proteid  molecule, 
47 

Colon,  the,  363,  364;  antiperistalsis 
in,  365-370 ;  changes  when  food 
enters,  370,  371,  372 ;  process  of 
clearing,  373-377,  381,  382,  384, 
387,  388 

Comminution,  98,  100,  loi 

Commonwealth,  the  S.  S.,  69 

Condiments,  influence  of,  261,  265 

Constipation,  cannot  exist,  43 

Constriction,  waves  of,  323,  340, 
341 

Cooked  flesh,  requires  mastication, 
97,  174 

Cooking,  influences  vegetable  more 
than  mineral  food,  118;  effect  of, 
389,  39«-396 

Comaro,  Luigi,  reformed  manner  of 
living  of,  ix;  his  autobiography,  x, 
xvi,  xvii  ;  Dr.  Van  Someren's 
paper  upon  his  theory  of  living,  26- 
46 ;  his  treatise  on  the  "  Sure  and 


Index 


Certain    Method    of    Attaining    a 

Long  and    Healthful    Life,"    28 ; 

Addison's  comments  upon  his  work, 

28,  92 
Craving  for  food,  256 
Cream,  experiments  with,  38-39,  43 
Cuba,  xiv,  70 
Curr,  E.  M.,  125,  129 


Dastre,  Dr.  Prof.  A.,  67,  68 

Day,  experiments  of,  337 

Defecation,  373-377 

Deglutition,  Magendie's  theory  of, 
284,  285  ;  movements  of,  285  ;  di- 
vided into  three  parts,  285  ;  Falk's 
and  Kronecker's  theory  of,  286 ; 
the  X-ray  method  in  the  study  of, 
287-295  ;  phenomena  of  cesophag- 
eal,  298-300 

reflex,  the,  287 

Dental  caries,  causation  of,  161 

Dewey,  Dr.  Edward  Hooker,  and 
the  "No  Breakfast  Plan,"  396, 
397 

De  Witt,  Assistant  Surgeon,  Lieut. 
Wallace,  in  command  of  soldiers  in 
the  Yale  investigation,  xiii,  70 

Dextrine,  170,  171,  392,  393,  395 

Diaphragm,  the,  324,  326 

Diet,  best  manner  and  system  of,  xiii ; 
the  optimum,  xxxi ;  minimum,  74  ; 
the  anthropoid  stage,  116;  the  pre- 
cooking  human  stage,  117;  the  pre- 
agricultural  cooking  period,  iiS; 
the  early  agricultural  age,  119;  the 
late  agricultural  period,  120;  for 
children,  130-132;  relationship  be- 
tween appendicitis  and,  141 

Dietary  Ten  Commandments,  5 

Dietetics,  precepts  of,  272 


Digestion,  appetite  the  most  impor- 
tant factor  in,  6 ;  the  true  chemical 
end-point  of,  10-11  ;  effect  of  the 
mental  state  upon,  74,  145 ;  psychic 
influence  in,  180;  the  phenomena 
in,  251 ;  thorough  mouth-work  as 
an  aid  to,  389 

Digestion-ash,  the,  what  it  should  be 
like,  lo-ii,  14;  should  not  be  un- 
clean, 24;  in  experiments,  38-39, 
42,  43,  47>  5if  79,  83,  84,  85,  94 

Digestive  activity,  stopped  by  anger 
and  worry,  7 

canal,     the.      See     Alimentary 

canal,  the 

glands,  the,  analc^y  between  the 

innervation  mechanism  of  the  sali- 
vary glands  and,  188-190;  appetite 
the  strongest  of  all  stimuli  to,  263, 
280,  282 

juices,     the,     7 ;     appreciation 

necessary  to  stimulate  flow  of, 
7,  12,  96 ;  mastication  brings  the 
food  into  intimate  contact  with,  98  ; 
quantity  of,  267  ;  relation  of  milk  to 
the  secretion  of,  274,  383,  386 

Digitalis,  281 

Diphtheria,  149 

Disease,  caused  by  indiscretions  in 
eating,  x,  xxxi;  follows  disobedi- 
ence, 29 

Disobedience,  disease  follows,  29 

Distention,  144 

Distress,  effect  of,  388 

Dog,  the  experiments  upon,  181,  194- 
211,  212-246,  249,  254,  258,  263,  279, 
280,  285,  292,  293,  297,  298,  299, 
303,  310.  3"i  313,  314.  315.  336, 
344 

Dolomites,  the,  26 

Drinking,  too  much,  xix,  95 

Dry  food,  97 

Dunn,  Miss  Eva,  122 

[413] 


Index 


Duodenum,  the,  303,  315,  356,  360 
Dyspepsia,    dangers    of,    xv ;    might 
cease  to  exist,  35 


E 


Eat,  how  to,  19 

Eating,  too  much,  ix;  indiscretions 
of,  X,  xix,  xxix,  29,  95,  135  ;  too 
fast,  20;  systematic  inattention  to, 
259,  260 ;  English  have  made  a  cult 
of,  261 

Economic  nutrition.  See  Nutrition, 
economic 

Efferent  nerves,  184,  185 

Efficiency,  human,  the  measure  of, 
XXX ;  research  into  causes  for,  54 

Eggs,  experiments  with,  38,  43,  78, 
95,  100,  137,  277 

"  Encyclopsedia  Britannica,"  the,  27 

Enemata,  the,  367,  379,  380,  388 

Energy,  the  minimum  transforma- 
tion of,  59 

,  potential,  59 

Engine,  an,  the  body  considered  as, 

English,  the,  have  made  a  cult  of  the 

art  of  eating,  261 
Emetic,  an,  325 

Emotion,  inhibition  of  stomach  move- 
ments during,  337 ;  effect  of,  383- 
384,  388 
Empiricism,  medical  practice  largely 

based  upon,  52 
Esquimaux,  the,  118,  123,  125,  126 
Esselmont,  experiments  of,  383 
Evolution,  Nature's  plan  of,  xi 
Ewald,  experiments  of,  313,  314 
Excess,    habitual,   confirmed  by  ex- 
periments, ix 
Excrements.     See  Digestion-ash,  the 
Excretia.     See  Digestion-ash,  the 
Exercise,  necessity  of,  xxix 


F^CES,  the,  374.  See  also  Diges- 
tion-ash 

Falk,  Dr.,  284  ;  theory  of  deglutition 
of,  286 

Fallopius,  on  the  functions  of  the 
stomach,  302 

Farinaceous  food,  395 

Fasola,  experiments  of,  378 

Fat,  potatoes  need  not  produce,  21 ; 
78,  79,  80,  85,  86,  95,  98,  100;  ex- 
periments upon,  271,  272,  274 

Faucial  tonsils,  the,  influence  of  masti- 
cation upon,  148 

Fear,  effect  of,  388 

Fearthought,  404 

Featherman,  123 

Fibrin,  276 

Flesh  food,  reduction  of  craving  for, 
50 

Fletcher,  Horace,  Dr.  Van  Someren's 
comments  upon  the  case  of,  30- 
31  ;  his  experiments  confirmed  by 
Marckwald,  46;  Sir  Michael  Fos- 
ter's comments,  48  ;  the  Cambridge 
tests,  49-52;  the  Middletown  test, 
54-55,  60 ;   the  Yale  test,  75-91 

Flour,  132,  392,  393,  395 

Food,  mal-assimilation  of,  x;  length 
of  time  for  chewing,  xxxii ;  Dr. 
Kellogg's  estimate  of  amount  habit- 
ually used,  xxxiv ;  mouth-treatment 
of,  5 ;  how  to  masticate  and  swal- 
low, 8,  9,  31,  32;  actual  process  of 
mastication  described,  32-34;  im- 
portant bearing  upon  the  economy 
of  the  body  of  its  treatment  in  the 
mouth,  48-49 ;  its  function  to  supply 
material  from  which  the  body  de- 
rives necessary  energy,  72 ;  any  ex- 
cess an  incubus,  72-73  ;  classified 
under  three  heads,  78;   in  excess, 


[414] 


Index 


produces  a  large  amount  of  unnec- 
essary work,  80 ;  its  nutritive  value 
determined  by  the  thoroughness  of 
its  digestion,  79;  softness  of,  129; 
mastication  tends  to  reduce  amount 
of,  136 ;  should  be  eaten  with  inter- 
est and  enjoyment,  252  ;  passionate 
craving  for,  256 ;  its  nutritive  value 
should  be  considered  rather  than 
taste,  261 ;  the  acid  reaction  of,  269  ; 
relative  nutritive  values  of  different, 
275,  276;  experiments  upon  the 
utilisation  of,  275 ;  effect  of  the 
movements  of  the  stomach  upon, 
328 ;  circulation  of,  329 ;  experi- 
mental investigation  of  the  influ- 
ence of  mastication  and  cooking  of, 
389-396 

Foster,  Sir  Michael,  xxiv,  xxv,  26 ; 
his  note  upon  Dr.  Van  Someren's 
paper,  48-52  ;  emphasises  the  want 
of  exact  knowledge  of  nutrition,  52, 
53,  67,  68,  91 

Fowls,  experiments  upon,  299 

Fruitarians,  the,  90,  397 

Fruit  sugar,  169 

Fruits,  43  ;  under-ripe  and  over-ripe, 
141.  395.  396;  usefulness  of,  397 

Fubini,  experiments  of,  383 

Fundus,  the,  317,  322,  323,  324,  325, 
330,  333,  334,  335,  336,  337,  340 


Galen,  on  the  functions  of  the 
stomach,  302 

Gastric  catarrh,  249 

digestion,  309,  316 

glands,  the,  182 ;  the  vagus  and 

the  sympathetic  nerves  exciters  of, 
183,  198;  mechanical  and  chem- 
ical stimulation  of  the  cavity  of  the 
mouth  has  no  effect  on,  201 ;  psychic 

[4 


excitation  of,  205;  sleep  exercises 
no  restraining  influence  upon,  206  ; 
the  simultaneous  excitation  of  the 
different  sense  organs  the  first  and 
strongest  impulse  toward  activ- 
ity of,  210;  psychic  secretion  the 
normal  commencement  of  secretory 
activity  on  the  part  of,  214;  con- 
ditions upon  which  depends  the 
secretory  work  of,  227  ;  mechanical 
stimulation  of,  237,  245,  249,  271, 
272,  274,  280 

Gastric  juice,  the,  appreciation  neces- 
sary to  stimulate  flow  o^  7 ; 
destroys  micro-organisms,  41 ;  its 
flow  increased  by  mastication,  102, 
146;  secretion  of,  181,  206,  208,211, 
213,  262  ;  connection  between  the 
appetite  and,  265, 266  ;  experiments 
for,  267;  too  little,  270,  272,  273; 
salts  of  sodium  promote  a  flow  of, 
277,  279,  280,  329,  334,  335,  337, 
34o>  341 

mechanism,  the,  385 

movements,  the,  301 ;  early  writ- 
ings on  subject  of,  302;  later  ex- 
periments upon,  303,  327,  329,  338 

mucous  membrane,  the,  excita- 

bUity  of,   181.  231,  241,  249,  258, 
259,  264 

muscular  fibres,  the,  307 

"  Gastric  tonics,"  255 

Gastritis,  inefficient  mastication  may 
produce,  138 

Gastro-intestinal  catarrh,  144 

Gastronomic  enjoyment,  increased  by 
proper  mastication  and  insalivation, 
22 

Germany,  food  in,  267 

Ginger,  preserved,  141 

Gladstone,  William  E.,  his  theory  of 
mastication,  92 

Gland  metabolism,  277 

5] 


Index 


Glinski,  Dr.,  190,  194,  196,  197 

Gluten,  raw,  395 

"Glutton   or    Epicure,"   26,   31,   92, 

389,  396.     See  also  "  New  Glutton 

or  Epicure,  The  " 
Goose,  the,  experiments  upon,  288 
Goose-fet,  100 
Gorilla,  the,  115 
Gran  Chaco  Indians,  the,  123 
"Grape-sugar,  chemically  made   from 

cane-sugar,  21,  169 
Greens,  132 
Grey,  Sir  George,  128 
Griddle-cakes,  need  not  be  hurtful,  21 
Griffin,  Charles  &  Company,  180,  181 
Griitzner,   experiments  of,   278,   346, 

363,  377,  378,  381 
Gscheidlen,  235 

Guinea-pigs,  experiments  upon,  39 
Gum  arable,  chewing,  103 
Gustatory  indifference,  263 

nerves,  the,  263,  269 

Gut,  the,  344,  345 »  3S5»  360,  364,  365, 

374 

H 

HAEMORRHOIDS,  cannot  exist,  43 

Haller,  experiments  of,  304;  his  sum- 
mary of  the  motor  functions  of  the 
stomach,  304-305,  309 

Harvard  Medical  School,  68 

Physiological  Laboratory, the, 284 

Haste,  danger  of,  134-135 

Headache,  produced  by  inefficient 
mastication,  138 

Health,  the  optimum,  xxxi 

Hearing,  the  sense  of,  210 

Heart,  the,  stimulated  by  mastication, 
96,  103,  281 

Heartburn,  144 

Heat  values,  397 

Heger,  Dr.  Prof.  Paul,  67,  68 

Heidenhain,  181,  182,  183,  235 

[41 


Herbivora,    the,    practice    thorough 

mastication,  97 
Higgins,    Dr.    Hubert,   letter    from, 

xxvii-xxxiii,  47 
Hirsch,  experiments  of,  305,  315 
Hofmeister,  experiments  of,  305,  308, 

309,  310,  311,  313,  314,  326,  327, 

332 
Hopkins,   Dr.  F.  Gowland,  26;   his 

paper  upon    the   isolation   of   the 

tryptophane  element  of  the  proteid 

molecule,  47 
Hors  d^aeuvre,  266 
Horse,  the,  experiments  upon,   293, 

294,  300 
Hospital  Corps,  the,  at  New  Haven, 

xiii,  70 
Hunger,  241 ;  "  the  best  sauce,"  254 
Hyperacidity,  145 
Hyperaemia,  345 
Hyperchlorhydria,  144,  147 


"  Igniting  juice,"  260 
Ignorance,  dietic,  sin  of,  xvii 
Ileocaecal  valve,  the,  355,  362 ;  the 
competence  of,   362-364,  367,   370, 
376,  381,  387,  388 
Ileum,  the,  363,  364,  367,  370,  382, 

387 
India,  82,  128 
Indians  of  Honduras,  the,  124 

of  Nicaragua,  the,  124 

of  North  California,  the,  122, 126 

Indigestion,     x ;     dangers    of,     xv ; 
caused   by   anger    and  worry,    7 ; 
"bunching  hits"  to  oppose,  13-16 
Indol,  the  odourous,  47 
Industries,  the,  mastication  in,  124 
Infant  life,  action  of  saliva  in,  36 
Innervation  mechanism,  an,  constitu- 
ent parts  of,  184 


6] 


Index 


Insalivation,  defined,  8,  22  ;  increases 
gastronomic  enjoyment,  22,  46,  48 ; 
its  striking  effect  upon  appetite,  50, 
60;  effects  of,  74,  89,  92,  93,  96; 
mastication  promotes,  loi 

Insane,  the,  forced  feeding  of,  268 

Instinct,  human,  the  outcome  of  every- 
day experience,  251  ;  physiology 
merely  confirms  the  precepts  of, 
251  ;  provisions  for  digestion  made 
by,  267;  demands  of,  272 

Intemperance,  95 

International  Congress  of  Physiolo- 
gists, the,  26,  48,  56,  68,  91 

Laboratory    of    Research,    the, 

proposal  to  found,  55-69;  sugges- 
tions as  to  staff  and  personnel,  62  : 
estimate  of  initial  outlay,  63  ;  sug- 
gestions as  to  location,  63  ;  sugges- 
tions as  to  management,  66 

Intestinal  anaemia,  345 

canal,  the,  39,  346 

contents,  the,  rhythmic  segmen- 
tation of,  347-355.  386 

digestive  juices,  the,  361 

mechanism,  the,  385 

movements,  difficulties  of  investi- 
gating, 342 ;  the  best  known  of,  343 

secretion,  61 

wall,  the,  344,  381,  386 

Intestine,  the  large,  activity  of,  343 ; 
movements  of,  364-377*  379»  3^6, 
387,  388 

,  the  small,  343,  346  ;  the  move- 
ments of,  347-362,  366;  course  of 
food  in,  360-362,  365,  367,  369,  378, 
381,  383,  385.  386,  387,  388 

,  the,  action  of  the  bacteria  in, 

39  ;  micro-organic  action  in,  40,  80, 
92 ;  much  more  sensitive  than  the 
stomach,  139,  301,  317,  328,  337, 
341 ;  studied  by  means  of  the 
Rontgen  rays,  342-388,  395 

27  [4 


Jaffa,  Professor,  90 ;  and  the  fruit- 
arians, 397 

Japan,  82 

Jaws,  the,  mastication  stimulates  the 
nutrition  o^  96,  103,  155 ;  influence 
of  mastication  upon,  109,  148  ; 
changes  during  man's  evolution  in, 
115-121 ;  instances  of  vigorous  use, 
122 

Johns  Hopkins  University,  68 

"  Journal  of  Physiology,  The"  (Amer- 
ican), 284,  301,  342 

(English),  47 


Kais  Root,  123 

Kane,  Dr.,  125 

Kara,  124 

Katabolic  action,  41 

Katabolism,  95 

Kellogg,  Dr.  J.  H.,  xxvii ;  letter 
from,  xxxiii-xxxv  ;  his  estimate  of 
amount  of  food  habitually  used, 
xxxiv ;  tribute  to,  391 ;  his  experi- 
mental investigation  of  the  influ- 
ence of  mastication  and  cooking  of 
food,  391-396 

Mrs.  J.  H.,  389 ;  tribute  to,  391 

Kelp,  122 

Kotljar,  experiment  by,  317 

Kreuznach,  46 

Kronecker,  Dr.  Prof.  Hugo,  67,  68, 
284,  285  ;  theory  of  deglutition  of, 
286 

Kumagawa,  experiments  of,  81 

Kwas,  267,  269,  270 


Lactic  aod,  prepared  in  the  stomach, 
269,  393,  394 

7] 


Index 


♦'  Lancet,  The,"  8,  26,  31 ;  Dr.  Camp- 
bell's articles  from,  92-179,  145 

Lard,  272 

Laws  of  Nature,  health,  strength,  and 
moral  tone  dependent  upon  proper 
fulfilment  of,  73 

Leonard!,  Dr.  Professor,  26 

Life,  right  conduct  of,  xiii ;  the  essen- 
tials and  sequence  in,  399 

Lippincott,  J.  B.  &  Company,  180, 
181 

Liqueurs,  266 

Liquids,  how  to  treat,  9,  34,  93,  94,  95 

LobassofT,  Dr.,  experiments  by,  217, 
218,  220,  222,  226 

Lobster,  137,  141 

London,  65 

Lower  Californians,  the,  123 

Ludwig,  experiments  of,  342 

Lumen,  the,  374 

Lymph,  influence  of  the  contraction 
of  the  masticatory  muscles  on  local 
circulation  of,  107,  148,  149,  355 


M 

Macaroni,  132 

cheese,  100 

Mackerel,  141 

Madrid,  69 

Magendie,   theory  of  deglutition  of, 

284 
Maize,  chewed,  124 
Mal-assimilation,  of  nutriment,  x,  xxi ; 

"  bunching  hits  "  to  oppose,  13-16  ; 

dangers  of,  24,  35 
Malay,  128 
Mall,   experiments  of,  343,  345,  354, 

378 
Mal-nutrition,  causes  of,  xxi,  35 
"  Malt  extracts,"  102 
Maltose,  starch  turned  into,  10 1,  170, 

392.  393 

[41 


Man,  the  First  Assistant  of  Nature, 
xi  -,  his  disparity  due  to  ignorance, 
xii ;  absurdity  of  his  ignorance,  4, 23 ; 
experiments  upon,  300 ;  by  nature 
a  frugivorous  animal,  395 

Maple  sugar,  84 

Marckwald,  Max,  paper  *'  On  Diges- 
tion of  Milk  in  the  Stomach  of  Full- 
grown  Dogs,"  46 

Masticate,  how  to,  19 

Mastication,  ineflScient,  causation  of, 
129  ;  must  lead  to  many  evils,  129 ; 
evils  resulting  from,  135 ;  conduces 
to  excessive  eating,  135  ;  may  cause 
suffocation,  137 ;  may  produce  gas- 
tritis, 138;  excess  of  starch  may 
pass  into  stomach  because  of,  141 ; 
prevents  a  sufficient  amount  of 
alkali  to  pass  into  the  stomach, 
146 ;  causes  evils  with  the  jaws  and 
their  appendages  and  the  adjacent 
structures,  148  ;  responsible  for  ade. 
noids,  148-152 ;  a  potent  cause  of 
Rigg's  disease,  159;  secondary  evils 
of,  164,  394 

,   proper,  increases   gastronomic 

enjoyment,  22,  46,  48,  60;  effects 
of,  74,  89 ;  Dr.  Campbell's  observa- 
tions upon,  96-173  ;  the  effects  of, 
96;  primary  object  of,  96;  pro- 
motes flow  of  saliva,  96,  :  ji ;  stimu- 
lates the  heart  and  circulation,  96, 
103 ;  influences  the  nutrition  of  the 
jaws,  96, 103  ;  facilitates  swallowing^ 
97;  brings  the  food  into  intimate 
contact  with  the  digestive  juices, 
98;  increases  amount  of  alkaline 
saliva  passing  into  the  stomach,  96, 
102  ;  acts  reflexly  upon  the  stomach, 
102  ;  the  muscles  of,  104 ;  its  influ- 
ence upon  the  jaw-bones,  109 ;  its 
influence  upon  the  teeth,  no;  in 
the  preparation  of  beverages,  123 ; 

8] 


Index 


in  the  industries,  124 ;  the  instinct 
of,  126;  the  causation  of  inefficient, 
129;  less  opportunity  than  formerly 
for,  130-133  ;  defective  apparatus 
for,  133  ;  affected  by  individual  dif- 
ferences, 134  ;  tends  to  diminish 
amount  of  food  consumed,  136; 
most  effective  way  to  secure  starch 
digestion,  145  ;  effect  upon  the  nasal 
passages,  naso-pharynx,  and  faucial 
tonsils,  148;  fast  becoming  a  lost 
art,  157 ;  means  of  insuring  ade- 
quate, 164,  389;  experimental  in- 
vestigation   of    the    influence    of, 

391 

Masticatory  instinct,  the,  126-129 

muscles,  the,  104;    influence  of 

their  contraction  on  local  circulation 
of  blood  and  lymph,  107,  148 

Matri,  128 

Meadville,  Penn.,  396 

Measles,  149 

Meat,  78 

broth,  266  ;  an  important  chem- 
ical excitant  of  gastric  secetion, 
266,267 

extract,  268 

juice,  268 

Mechanical  stimulus,  great  impor- 
tance assigned  to,  257 

Medical  practice,  largely  based  upon 
empiricism,  52 

science,  not   possessed  of  final 

information  concerning  questions  of 
nutrition,  52 

Medicine,  ideal  only  when  it  can  take 
its  proper  position,  249 ;  physiology 
can  make  no  pretence  to  guide  the 
field  of,  251  ;  to  what  it  will  at  length 
grow,  251;  treats  too  lightly  the 
loss  of  appetite,  256 

Melanesia,  128 

Melanesians,  the,  120 


Meltzer,    Dr.,    284;    experiments  of, 

294,  296,  297,  298 
Mendel,  Dr.  Lafayette  B.,69 
Mendel  Pass,  bet  Bozen,  Siid  Tirol, 

Austria,  exp)eriments  at,  26 
Mental  energy,  41 

state,  12  ;  its  eflfect  upon  diges- 
tion and  nutrition,  74 
Menticulture,    physical    and  mental 

equipments  necessary  to  promote,  7 
"  Menticulture,"  xxi,  xxiv 
Metabolism,    37 ;    determination    of, 

40 ;        calorimetric        trial-balance 

measurement  of,   54 
Micro-organisms,    40;   destroyed  by 

acid   gastric  juices,  41 
Middletown,  Conn.,  experiments  at, 

54 

Milk,  how  to  drink,  9;  experiments 
in  drinking,  36,  38-39,  78,  84,  93, 
94,  268 ;  takes  a  special  position 
among  foods,  272  ;  the  three  prop- 
erties of,  273 ;  its  relation  to  the 
secretion  of  the  digestive  juices, 
274,  275,  276,  277 

pudding,  97,  143,  172 

"  Modem  Medicine,"  389,  391 

Modoc  Indians,  the,  123 

Moist  foods,  97 

Mnritz,  experiments  of,  324,  328,  332 

Mosso,   Dr.     Prof.    Angelo,  67,    68 

284,  285 

Mouth,  the,  should  do  all  it  can,  93, 
180;  examination  of,  174-179;  rins- 
ing, 179 ;  mechanical  and  chemical 
stimulation  of  the  cavity  of,  201, 

285,  286 

breathing,  evils  of,  151-153 

discrimination,  94 

thoroughness,  8 

treatment,  of  food,  5,  12,  92;  a 

preliminary  necessity  of  easy  diges' 

tion,  180,  389 


[419] 


Index 


Mucosa,  the,  343,  355 
Mucous  membrane,  the,  346 
Munich,  56,  76,  81 
Muster,  128 
Mutton,  100 

N 

Nansen,  J.  F.,  123 

*  Napoleon,  died  from  fast  eating,  138 

Nasal  passages,  the,  effect  of  masti- 
cation upon,  148 

Naso-pharyngitis,  144,  148,  149 

Naso-pharynx,  the,  influence  of  mas- 
tication upon, 148 

National  Academy  of  Sciences,  the, 
contribute  to  fund  for  research,  69 

Natural  Automatic  Processes,  3,  180 

Nature,  plan  of  evolution  of,  xi; 
Man  the  First  Assistant  of,  xi ;  her 
reward  for  conformity  with  her 
requirements,  xii ;  her  generous 
assumption  of  forty-seven  forty- 
eighths  of  labour,  5,  12;  given  an 
opportunity  by  economic  nutrition, 
22 ;  her  plans  perfect  if  lier  laws 
are  obeyed,  29;  never  intended  a 
special  diet  or  bottle  of  medicine, 
30;  endeavours  to  prepare  lactic 
acid  in  the  stomach,  269 

Negritos,  the,  118 

Negroes,  the  African,  120 

Nerve  cells,  the,  specific  qualities  of, 
187 

fibres,  184 


*  While  Napoleon  was  building  his 
power  and  fame  he  was  very  careful 
and  abstemious,  but  in  later  life  suc- 
cumbed to  luxury  and  gluttony  ;  Bis- 
marck's rise  and  decline  were  simi- 
larly related  to  dietary  influences. 
—  H.  F. 


Nervous  system,  the,  influence  upon 

the  glands  of,  183 
Neutralisation,  92 

"  New  Glutton  or  Epicure,"  the, 
xxviii,  47.  See  also  "Glutton  or 
Epicure  " 

New  Guinea,  124 

New  Haven  (Conn.),  scientific  exper- 
iments at,  xiii  54,  71.  See  Yale 
investigation,  the,  and  Yale  test, 
the 

Nitrogen,  85,  86 

Nitrogenous  equilibrium,  86 

measurements,  tests  of,  26 

"  No  Breakfast  Plan,"  the,  396 

Nothnagel,  experiments  of,  343,  345 

Northwest  London  Hospital,  the,  8, 
92 

Nutarians,  90 

Nutrient  enemata,  367,  379,  380,  382, 
388 

fluid,  381 

Nutriment,  selection  of,  7 

Nutrition,  economic,  experiments  upon 
problem  of,  ix,  x,  48-52  ;  active  in- 
terest now  taken  in,  x ;  the  financial 
saving  the  least  of  the  profits  in,  xi ; 
the  key  to  England's  welfare,  xxv  ; 
attitude  of  the  scientific  mind  to- 
wards, xxvii ;  little  accurate  knowl- 
edge concerning,  xxx ;  psychology 
of,  6-7  ;  appetite  the  most  impor- 
tant factor  in,  6 ;  mechanical  and 
chemical  physiology  of,  8  ;  its  entire 
principle  simple  and  practical,  ig ; 
does  not  advise  avoiding  starchy 
foods  for  stout  people,  21 ;  assures 
that  the  same  food  will  add  or 
decrease  weight,  21;  keeps  one  in 
perfect  condition,  22 ;  its  require- 
ments not  hardships  but  pleasures, 
22 ;  not  a  joke  or  fad,  24 ;  an  appeal 
to  self-examination  and  self-instruc- 


[420] 


Index 


lion,  24,  25;  first  scienrific  recogni- 
tion of  principles  of,  26;  medical 
science  not  possessed  of  final  infor- 
mation concerning  questions  of,  52 ; 
plan  for  institution  of  an  interna- 
tional inquiry  into  the  subject  of, 
53-55;  proposed  to  found  an  inter- 
national laboratory  of  research  for 
the  study  of,  55-68 ;  no  question  of 
greater  importance,  72  ;  poverty  and 
vice  traced  to  perversion  of,  73; 
great  need  of  thorough  physiological 
study  of,  74;  effect  of  the  mental 
state  upon,  74 

Nutrition,  animal,  56,  57,  58 

Nutritive  equilibrium,  37;  experi- 
ments in,  37-39 

Nuts,  141,  173  ;  usefiilness  of,  397 

Nuttall,  Dr.  George  H.  F.,  26,  39,  47 


O 

(Esophagus,  the,  may  protect  the 
stomach,  139;  192,  285,  286,  289, 
291,  292,  297,  299,  300, 303,  304,  307, 
316,  325,  326,  336,  34» 

Openchowski,    experiments   of,   305, 

325 
Orang, the,  115 
Oranges,  169 
O'Reilly,  Surgeon-General,  xvii,  69, 

70 
Ozawa,  Professor,  55 


Pabulum,  the,  derivation  of,  40,  41 

Pacific  Islands,  the,  124 

Padua,  Italy,  28 

Palate,  the,  "  the  dietetic  conscience," 

75 
Pancreas,  the,  excited  by  the  vagus 
and  the  sjmipathetic  nerves,    183, 


[42 


270;  special  relations  of  acids  to, 
270,  271,  273,  274,  279 

Pancreatic  digestion,  395 

gland,  the,  269,  270,  271,  280 

juice,  the,  experiments  for,  367, 

270,  273,  279,  360,  395 

Paris,  56,  65 

Pastry,  132,  172 

Patagonians,  the,  128 

Pathology,  249 

Paria,  University  of,  26 

Pawlow,  Dr.  Prof.  J.  P.,  6,  7,  12; 
researches  of,  61 ,  67,  68 ;  his  demon- 
strations of  psychic  influence  in 
digestion,  180-283 

Peas,  132 

Pendelhewegung^  the,  342 

Pendulum  movement,  the,  358-360 

Penegal,  xxxiii 

Peptic  digestion,  318,  335 

Peristalsis,  327,  330,  333,  337,  340, 
343,  344,  346,  348,  355-357,  361, 
365,377,  378,  383,  384,  386,  38S 

Peristaltic  wave,  the,  343,  353,  3^5 

Pfiiiger's  Archives,  182 

Pharynx,  the,  285,  286,  290,  298 

Philippines,  the,  69 

Physicians,  most  of  them  called  on  to 
restore  appetite,  254  ;  their  indif- 
ference to  appetite,  257 ;  in  Russia, 
260 ;  should  bear  in  mind  the  ques- 
tion of  psychic  secretion,  261 

Physiology,  applied,  251 

Pine-apple,  141 

Pitcherie,  chewing,  129 

Polynesia,  128 

Poorer  classes,  the,  appetite  stronger 
among,  253 ;  food  of,  266,  267 

"  Popular  Science  Monthly,  The," 
xxxiii,  53;  Professor  Chittenden's 
article  in,  69-91 

Pork,  100,  141 

Porridge,  97,  143,  172.  270 

I] 


IndeL 


Potato,  made  digestible  by  saliva,  20 ; 
if  masticated,  need  not  produce 
fat,  21;  experiments  with,  38,  102; 
yields  abundant  sugar  by  long- 
continued  mastication,  142,  146 

Potatoes,  boiled,  143,  172 

Poverty,  traced  to  perversion  of  nu- 
trition, 73 

Proteid,  demanded  by  the  appetite, 
xxxii ;  the  putrid  decomposition  of, 
47;  minimum  amount  of,  74;  78, 
79.  Asiatics  consume  smaller  pro- 
portion of,  82,  83,  85,  98,  100,  272, 
394 

,  the  high,  xxxii,  xxxiii 

,  the  lowjxxxi,  xxxii,  xxxiii 

digestion,  perfect,  394,  395 

molecule,   the,   isolation  of  the 

tryptophane  element  of,  47 

Physiology,  experimental,  249;  can 
make  no  pretence  to  guide  the  field 
of  medicine,  251 ;  merely  confirms 
the  precepts  of  instinct,  251 

Psychic  environment,  12 

excitation,  259 

influence,  in  digestion,  180-283 

juice,  the,  213,  257,  267 

secretion,  261 

stimulation,  249 

Pultaceous  foods,  95,  97 

Pyloric  sphincter,  the,  movements  of, 
314 

Pylorus,  the,  stands  guard  over  the 
intestines,  139,  141  ;  observations 
of  Fallopius  upon,  302  ;  ideas  of 
early  writers  concerning,  303  ;  later 
experiments,  304,  307,  308,  S'Si  3»6, 
3i7»  325,  326,  328,  330,  331,  332, 
333.  340,  341,  360 

R 
Rabbit,  the,  experiments  upon,  344, 
359.  37« 

[42 


Rage,  effect  of,  388 

Raiser,  experiments  of,  359,  371 

Rectal   injections,   stimulating  effect 

on  movements  of  small  intestine  of, 

367 
Rectum,  the,  374,  379,  382 
Reed,  Dr.  Major  Walter  (martyr  to 

science),  70 
Regina  Margherita  Laboratory,  the, 

summit  Monte  Rosa,  64,  68 
Regurgitation,  35 
Rhinitis,  144,  148,  149 
Rhythmic  segmentation,  of  the  intes- 
tinal   contents,   347-355,   3S8,   360, 

362,  383,  386 
Rice,  82,  132 
Rickets,  144 
Rigg's  disease,  159,  163 
Rjasanzew,  Professor,  experiments  oi, 

275 
Roberts,  Sir  William,  75,  147 
Rockefeller,  John  D.,  xxxv 
Institute  of   Preventive   Medi- 
cine, the,  68 
Rollbewegung^  345 
Rontgen    rays,    the.    Dr.    Cannon's 

studies  with,  180,  284,  287-300, 3oi~- 

34',  342-388 
Roosevelt,  President  Theodore,  70 
Root,  Secretary  of  War,  Elihu,  70 
Rosa,  Monte,  64,  68 
Rossbach,  experiments  of,  305,  309, 

3".  313,  3'4 
Roux,  experiments  of,  314,  315,  327, 

328 
Royal  Society,  the,  68 
Rumination,  35,  98 
Russell,  Dr.  William,  145 
Russia,  physicians  in,  260;   food  in, 

267,  272 
Russian  Imperial  Military  School  of 

Medicine,  the,  68 
peasant,  the,  270 


Index 


Sabbatani,  experiments  of,  378 

St.  Martin,  Alexis,  iuvestigadons  on, 

305.  309 
Saliva,  its  chemical  effect  upon  potato, 
20;  upon  syrup,  21,  33,  34,  35;  its 
action  in  infant  life,  36 ;  an  im- 
portant therapeutic  agent,  45,  93, 
94,  95  ;  mastication  promotes  flow 
of,  96,  loi  ;  dry  food  produces 
greater  flow  than  moist,  97,  147  ; 
complicated  physiological  functions 
of,  191-192,  337,  392,  393,  395,  396 

Salivary  digestion,  in  the  stomach, 
33Sf  341  ;  effect  of  mastication  and 
cooking  of  food  upon,  391 ;  imper- 
fect, 394 

■ glands,  the,  155;  analogy  be- 
tween the  innervation  mechanism 
and  the  glands  of  digestion,  188- 
190 ;  the  exciting  agencies  of  the 
nervous  mechanism  of,  igi ;  their 
particular  properties,  191-194 ;  dif- 
ferences between  the  exciting 
agencies  of  the  different,  194-198  ; 
Professor  Pawlow's  sham-feeding 
experiment,  19S-211,  280 

secretion,  excitants  of,  191 

Sapidity,  44 

Sauces,  269 

Schafer,  40,  82 

Schmidt,  experiments  of,  202,  304, 
231 ;  conditions  for  success,  204-206 

Schiitz,  experiments  of,  305,  308,  309, 
310,  311,  313,  314,  327,  332 

Schwartz,  experiments  of,  303,  304 

Scientific  Assessors,  Board  of,  67,  68, 
181 

Secretions,  digestive,  180 

Secretory  fibres,  183 

nerves,  266 

SegmenUtion,  386, 388 


Selection,  of  natriment,  7 
Self-nutrition,  secret  o^  zii 
Sensory  nerves,  187 
Sham  feeding,  experiments  in,  198- 
211,   214-246;    psychic  effect  may 
become  an  absolute  and  independ- 
ent factor  in,  209,  279 
Sheffield   Scientific  School,  the,  ex- 
periments at,  53,  68 
Sight,  the  sense  of,  210 
Sivdn,  experiments  of,  81 
Skatol,  the  odourous,  47 
Sleep,  exercises  no  restraining  influ- 
ence upon  the  gastric  glands,  206; 
effect  of,  383-386 
Smell,  the  sense  of,  310 
Snyder,  Dr.,  experiment  in  nutritive 

equilibrium,  37-38 
Society  de  Biologie,  the,  46 
Sodium,  salts  of,  277;  promote  a  flow 
of  gastric  juice,  277,  278,  279,  281, 
282 
Soft  foods,  97,  129,  136,  142,  160,  162 
Solid  foods,  94,  268 
Solray  Sociological  Institute,  the,  68 
Sorbonne,  Universitie  de  la,  68 
Soups,  266,  267 
South  Africa,  11 

America,  124 

"Spectator,"  the,  28 

Sphincter,  the,  315,  316,  317, 331, 333, 

341 
Spinach,  99 
Spirits,  93,  94 
Ssanozki,  Professor,  experiments  of, 

203,  228 
Starch,  needed  by  body.  20,  21,  78,  98  ; 
changed  into  maltose,  101,  102; 
datger  to  the  stomach  in  receiving 
an  excess  of,  141-146;  the  last  con- 
stituent to  leave  the  stomach,  145, 
170,  171,  172,  270,  337,  393,  395, 
639 

[4^3] 


Index 


Starling,    experiments   oA  343*  344, 
345.  346,  359 

Stews,  266 

Stomach,  the,  struggles  bravely  to 
overcome  abuse,  19;  man's  igno- 
rance concerning  requirements  of, 
23 ;  mastication  acts  reflexly  upon, 
102;  a  long-suffering  organ,  138; 
its  danger  of  receiving  an  excess  of 
starch,  141 ;  starch  the  last  con- 
stituent to  leave,  145  ;  necessity  of 
alkali  in,  146 ;  secretory  work  of, 
182,  183,  229  ;  secretory  nerves  of, 
210,  227 ;  the  seat  of  certain  definite 
sensations,  241  ;  the  initial  impulse 
towards  awakening  an  appetite  may 
originate  in,  244,  246 ;  no  material 
progress  in  the  physiology  of,  250; 
Nature  endeavours  to  prepare  lactic 
acid  in,  269 ;  acids  supplement 
weak  action  in,  270,  279;  catarrhal 
affections  of,  280 ;  gives  no  obvious 
external  sign  of  its  workings,  301 ; 
studied  by  means  of  the  Rontgen 
rays,  301-341  ?  Galen's  observa- 
tions on  the  functions  of,  302  ;  Fal- 
lopius's  views  upon,  302  ;  the  motor 
functions  of,  304 ;  the  anatomy  of, 
306 ;  its  relations  to  the  shadow, 
306;  the  musculature  of,  308; 
normal  movements  of,  309 ;  the 
peptonising  function  of,  314;  its 
appearance  at  various  stages  of 
digestion,  319;  composed  of  two 
physiologically  distinct  portions, 
324,  340 ;  its  movements  in  vomit- 
ing»  325  ;  effect  of  its  movements 
upon  the  food,  328 ;  attempts  to 
perform  function  of  teeth,  333 ; 
salivary  digestion  in,  335  ;  inhibi- 
tion of  its  movements  during  emo- 
tion, 337 
fluids,  393,  394 


SufFocatioii,  caused  by  inefficient  mas- 
tication, 137 

Sugar,  21,  78,  89,  95,  169,  337,  393, 
395 

Sugar-cane,  123,  124,  i6g 

"  Sure  and  Certain  Method  of  At- 
taining a  Long  and  Healthfui 
Life,"  Luigi  Comaro's  treatise 
upon,  28 

Swallowing,  facilitated  by  mastication, 
97  ;  mechanism  of,  284.  See  also 
Swallowing  Impulse,  the 

Impulse,   the,   xxxii,    8,    9,    93, 

94 

reflex,  Dr.  Van   Someren's,  26, 

44 

Sweet  potato,  124 

Sweets,  why  pleasant,  268,  269 

Sympathetic  nerve,  the,  an  undoubted 
exciter  of  the  gastric  glands  and  of 
the  pancreas,  183 

Syrup,  chemical  effect  of  saliva  upon, 
21 

T 

Tapioca,  132 

Taplin,  125 

Tasmanians,  the,  122 

Taste,  delicacy  of  the  sense  of,  22, 
23 ;  should  be  dissipated  in  the 
mouth,  93,  210;  necessary  to  give 
an  impulse  to  the  organs  of,  253 ; 
the  nutritive  value  of  food  should 
be  considered  rather  than,  261 

gratification,  93 

Tea,  132 

Tea-taster,  the  professional,  methods 
of,  23.  93 

Teeth,  the,  influence  of  mastication 
upon,  no;  changes  during  man's 
evolution,  115-121  ;  instances  of 
vigorous  use,  122-126;  irregularity 
in,  156;  evils  of  imperfect  use  of, 
157;  examination  of,  174-179;  the 


[424] 


Index 


stomach  attempts  to  perform  func- 
tion of,  333 

"Text-Book  of  Physiology,"  Scha- 
fer's,  40 

"That  Last  Waif;  or  Social  Quaran- 
tine," XXV 

Therapeuticexperiments,  pathological, 

249 
Therapeutics,  precepts  of,  272 
Thierfelder,  39 
Thirst,  95 
Thompson,  Dr.,  142 

Prof.  W.  H.,  180,  i8r 

Thorax,  the,  290 
Tobacco-chewing,  103,  129 
Tokio,  University  of,  55 
Tongue,  the,  needs  exercise,  154 
Tonic    constrictions,    the,    344;    the 

appearance  of,  370-373.  385>  387 

rings,  the,  373 

Tonsillitis,  144,  148 

Tooth-brush,  the,  177 

Tooth-powder,  178 

Toxins,  absorbed  into  the  blood,  40, 

41,  44j  143 
Training,  for  athletes,  why  itecessary, 

22 
"Traits  Analytique  de  la  Digestion," 

Blondlot's,  181 
Treves,  Sir  Frederick,  on  bolting  of 

food,  140,  141 
Trinity  College,  Dublin,  180 
Trophic  fibres,  183 
Tryptophane,  47 
Tuberculosis,  144 

Turin,  Italy,  Congress  of   Physiolo- 
gists at,  26,  48,  56,  91 
- — ,  University  of,  68,  284 

u 

Urinb,  should  be  inoffensive,  42,  93, 
»74 


Vagus  ner\^,  the,  an  undoubted  ex- 
citer of  the  gastric  glands  and  of 
the  pancreas,  183  ;  its  functions  al- 
most interminable,  183,  349 

Van  Someren,  Dr.  Ernest,  xxv,  7,  12  ; 
his  paper  "Was  Luigi  Comaro 
Right?"  26-46;  his  swallowing  re- 
flex, 26,  44;  his  experiments  con- 
firmed by  Marckwald,  46 ;  Sir 
Michael  Foster's  Note  upon  his 
paper,  48-52  ;  the  Cambridge  tests, 
49-52.  S3.  60,  91,  92,  98 

Van  Valzah,  146 

Veal,  100 

Veddahs,  the,  128 

Vegetable  food,  experiments  with ,  40 ; 
necessitates  more  thorough  masti- 
cation than  animal,  97,  98,  173; 
influenced  more  by  cooking  than 
animal,  118,  132,  170 

Vegetables,  43,  78 

Venice,  Italy,  30,  63,  64,  91 

Vermicelli,  132 

Vermicular  contraction,  343 

wave,  the,  345 

Vermiform  appendix,  the,"i40 

Vice,  traced  to  perversion  of  nutrition, 

73 

Vienna,  65 

bread, 131 

Vinegar,  269 

Vivisection,  303,  305 

Voice,  the,  requires  lusty  exercise  in 
youth,  149 

Volt  diet,  the,  76,  81,  84,  86 

Vomiting,  the  act  of,  193,  303  ;  move- 
ments of  the  stomach  in,  325,  341 

w 

Wallack,  Dr.  G.  Sim,  no,  113,  130, 
154,  158,  161,  169,  174,  177 


[4^5] 


Index 


Walther ,  Dr. ,  experiments  of,  267, 276 
Washington,  D.  C,  70 
Water,  how  to  drink,  9,  34,  95,  268, 
39i>  392 

biscuit,  391 

Weight,  must  become  normal,  43 
Welch,  Dr.  Prof.  William  H.,  67,  68 
Wepfer,  experiments  of,  303,  304 
Wheat,  unground  pearl,  392,  393,  394 

flour,  392 

Wine,  how  to  take,  9,  22,  23 
Wine-tasters,  the  professional,  meth- 
ods of,  23,  93 
Wolves,  experiments  upon,  303 
Wood,  Maj.  Gen.  Leonard,  69,  70 
Worry,  causes  indigestion,  7 
Wulfson,  Dr.,  197 


X-RAY.     See  Rontgen  ray 


Yale  investigation,  the,  x,  xi,  xiii- 
XV,  xvii,  xviii,  xix,  xxxiii 

Gymnasium,  the,  87 

test,  the,  5,  69,  75-91 

University,  68 


Z,  in  the  nutrition  alphabet,  10,  la 
Zuntz,  Dr.  Prof.  N.,  67,  68 


[426] 


581926 


3   1378  00581    9266 


RETURN  TO  the  circulation  desk  of  any 
University  of  California  Library 

or  to  the 

NORTHERN  REGIONAL  LIBRARY  FACILITY 

University  of  California 

Richmond  Field  Station,  BIdg.  400 

1301  South  46th  Street 

Richmond,  CA  94804-4698 

ALL  BOOKS  MAY  BE  RECALLED  AFTER  7  DAYS 

To  renew  or  recharge  your  library  materials,  you  may 

contact  NRLF  4  days  prior  to  due  date  at  (510)  642-6233 

DUE  AS  STAMPED  BELOW 


FEB  11 6  2008 


DD20  12M  7-06 


h^  fe 


^eJ^-Z.   of 


our  nutri- 


b  a^^l 


.«>.^»^*^^.a.^...>.^„uyi>.«l^,,^n. -p.,.,^--.-p^-p^.^-„._j.^^.^^^^^^^^ 


1 


THE  A.B:^.OF 

)UR  OWN  NUTRITION 

by 

Horace  Fletcher 


A.B.C.Life  Series 


TtiMriiimtmttfturnffiiiirtuijiMiiiJTiiaiifflilliiMMiJmwWI^^ 


